Spondylolisthesis is a spinal condition that occurs when one of the vertebrae slips out onto the bone below it. This can happen anywhere along the spine, but is most common in the lower back (lumbar) area. This malalignment of the vertebra can cause extreme pain and mobility issues. Left untreated, it can also cause further nerve damage.
If you are experiencing severe back pain as a result of Spondylolisthesis, you should consult an experienced disability attorney. They can help you to develop a plan to build your long-term disability insurance claim.
Types of Spondylolisthesis
There are 6 main types of Spondylolisthesis. They can happen as a result of an injury or in conjunction with other medical conditions. In addition to the type of Spondylolisthesis, your doctor may assign a “grade” to your condition. The grade refers to the severity of your slip. if your spine has slipped more than 50%, surgery becomes a viable treatment option. Below, we will break down the different classifications of this condition.
Type I: Congenital/Dysplastic
Congenital Spondylolisthesis, also called Dysplastic Spondylolisthesis, is an abnormality in the spine present at birth. In this type, the slip is a defect in the facet joints of the spine. Congenital Spondylolisthesis is a relatively rare condition, especially when compared to the rest of the classifications.
Type II: Isthmic
Isthmic Spondylolisthesis is the most common type of this condition. While it is divided into 3 subtypes, they refer to different affected areas. Generally, Type II refers to a defect in the bone that connects the upper and lower facet joints. Often, this defect is a fracture, which leads to the eventual slipping of the discs. Even small stress fractures in the vertebrae can lead to Isthmic Spondylolisthesis. The L5-S1 level of the spine is most commonly affected by Type II.
Type III: Degenerative
Degenerative Spondylolisthesis is when arthritis causes the spinal slip. Age and repetitive motions can cause damage to the cartilage and bone. This can cause pain, inflammation, and swelling. When the discs compress or weaken as a result, a slip may occur. Type III most commonly occurs in the lumbar or cervical spine.
Type IV: Traumatic
Traumatic Spondylolisthesis refers to slippage as a result of large forces acting upon the spine. This may be an excessive force from lifting or an accident such as a car crash. The high force causes damage to the neural arch. The neural arch is the ring of the bone surrounding the spinal cord. Fracturing this bone can cause the vertebrae to slide. Both the cervical and lumbar areas of the spine are generally affected by this type.
Type V: Pathologic
Pathologic Spondylolisthesis occurs when a spinal slip is caused by a weakness within the bone. Most commonly, this comes as the result of tumors, cancer, or other bone diseases. The weakening of the spinal bones can cause degradation and destruction of the posterior (back) portion of the vertebrae. While rare, this condition type can be especially dangerous because of the toll that the pathologic condition has already caused.
Type VI: Iatrogenic
Iatrogenic Spondylolisthesis occurs as a complication of spinal decompression surgery If the spine is decompressed without effective stabilization. During a spinal decompression surgery, a small amount of spinal bone is removed to relieve pressure and allow for the back to relieve tension. If too much bone is removed, the vertebrae can slip. Generally, surgeons try to avoid this complication by using stabilization techniques during more intense decompression surgeries.
Symptoms of Spondylolisthesis
While symptoms may vary by type and severity, most of the common symptoms involve back and nerve pain. Below, we will list the different symptoms that are most common across the board for this condition. Your doctor will be able to give you a more thorough list of all of the symptoms for your specific classification of Spondylolisthesis.
Primary symptoms include:
- Lower back pain, often worse when standing/walking
- Relief of back pain when sitting/bending
- Pain radiating to your from the back to the thighs
- Tight hamstrings
- Numbness, pain, or tingling from the back down one leg (sciatica)
- Tenderness in affected vertebra
- Leg weakness
- Semi-kyphotic posture (forward-leaning)
- Waddling gait
- Changes to bladder/bowel function
If you are experiencing painful chronic symptoms, consult a doctor. They will be able to help you with diagnosis and treatment for your Spondylolisthesis or other spinal condition.
Diagnosing Your Spondylolisthesis
While a diagnosis of your condition alone will not often be sufficient to build your long-term disability insurance claim, it is still important. A diagnosis from your doctor usually starts with a physical evaluation of your back. From there, you will likely undergo imaging tests to help confirm the diagnosis. An X-ray will show any cracks, fractures, or slippage. Additionally, CT scans or MRIs may help with further confirmation of diagnosis. Furthermore, they can help doctors assess what treatments may be needed. If you have pain, numbness, or weakness in the legs, an MRI may also be able to document the effects of these symptoms. All 3 imaging tests can be submitted as objective medical evidence to support your disability claim.
Appropriate Treatment for Spondylolisthesis
When filing for long-term disability insurance for Spondylolisthesis, you will need to show that you are receiving “Appropriate Treatment” for your condition. Furthermore, the insurance company will want to see that you are compliant with treatment as you collect benefits. Otherwise, they may cancel your benefits under their “non-compliance” clause.
Treatment for this condition can vary, depending on the severity of the slippage, and the affected vertebra. Generally, a non-invasive treatment plan will be recommended for less severe shifts. Non-invasive treatments include:
- Pain medications (NSAIDS and/or Tylenol)
- Physical therapy
- Hot/Cold treatments
- Epidural injections, including steroids
Surgical options are usually only employed if the slippage is life-threatening, or if the above has not been able to correct pain and other symptoms. Weakness or numbness of the legs may also be a cause for surgery. The surgical process for Spondylolisthesis works to realign the vertebrae by fixing them into place with a small rod. The rod is screwed into the spine to stabilize it. Bone graft or cage may also be used in some cases.