Does Spondylolisthesis Get Worse Over Time & Can It Cause Paralysis?
Spondylolisthesis is a condition where a bone in the vertebra or spine slips out of its position, either backward or forwards. It is most common in the lumbar spine or lower back; however, it may happen in the thoracic spine (upper back) or the cervical spine (neck). It is not the same thing as a slipped disc, where a spinal disc between a spine or vertebrae ruptures. In this article, we deal with a common question about it - does spondylolisthesis get worse over time and can it cause paralysis?
Does Spondylolisthesis Get Worse Over Time?
Spondylolisthesis should be taken care of very well. If not, it can cause extreme pain, tingling and burning sensations, numbness and pins and needles sensation. It may also get worse if the root cause of the condition is not taken care of. In case, the slipping of the vertebrae increases, the pain and the discomfort also increases. Hence, it is very essential to consider the condition a serious one and accordingly take the measures to prevent it from worsening.
Spondylolisthesis can affect adults but can sometimes also occur in kids. Any process occurring during growth and development or with aging can weaken the spinal vertebra and increase the risk of spondylolisthesis. As it is also related to degenerative changes, it can worse over time, if left untreated. However, this also depends on the severity of the condition, overall health, activity levels and use of the conventional treatment measures. Adults with lower grades of spondylolisthesis may not experiencing worsening over time, especially if appropriate treatment measures are taken. In children, the chances that spondylolisthesis gets worse over time are more as they grow through their puberty.(1) Timely diagnosis and early treatment can help in managing the condition well and prevent it from worsening.
Causes of Spondylolisthesis
There are several causes of spondylolisthesis. A vertebra can be defective right from the birth or a vertebra can be broken by a stress fracture or trauma. Additionally, vertebrae may be broken by disease or infection. This disorder can occur in adolescents and children who actively participate in athletics.
Symptoms of Spondylolisthesis
Many people do not realize that they have spondylolisthesis as it does not always cause symptoms.
Some of the symptoms of spondylolisthesis include the following:
- Lower back pain that gets worse during activity and while standing and it is calmed by lying down.
- Tenderness or stiffness in your back
- Excessive curvature of a spine
- Tight hamstring muscles
- Numbness, pain or tingling sensation from the lower back to your legs.
- The intensity of the symptoms varies significantly from one individual to another.
Diagnosis and Treatment of Spondylolisthesis
To diagnose spondylolisthesis physical examinations are the initial step. If you are suffering from this medical condition, you may have difficulty to raise your leg straight during simple exercises. X-ray of a lower spine is important to determine whether a vertebra is in place or not. Your physician may look out for bone fractures on X-rays. Your doctor may undergo CT scan too. Treating spondylolisthesis depends on the seriousness of pain and also vertebra slippage. Nonsurgical treatments help to ease pain and help the bone to go into its place. During the healing process, contact sports should be avoided.
Nonsurgical treatment methods include the following:
- Physical therapy exercises
- Wearing back braces
- Taking prescribed anti-inflammatory or over-the-counter drugs to reduce pain
- Using steroid injections.
Doctors recommend trying out nonsurgical methods of treatments first. However, if adults are suffering from severe pain then they may require a surgery, known as spinal fusion. Surgical correction of a misplaced vertebra is needed if a bone slips far down and when your spine does not respond to nonsurgical therapy. Surgery may be needed when the bones of a spine press on the nerves. The doctor may stabilize your spine through a metal rod or a bone graft. An internal brace may be put to support a vertebra when it heals. After the completion of the spinal fusion, it takes 4-8 months to fuse the bones together. The rate of success of this surgery is high.
Degenerative spondylolisthesis is basically because of wear and tear of the spine, which breaks down the vertebral components. It can be progressive; it can damage and can become worse with time. Additionally, it may result in stenosis, narrowing of the spinal cord and spinal canal compression. When stenosis is extreme and non-operative treatments fail, surgery may be needed.
Can Spondylolisthesis Cause Paralysis?
Spondylolisthesis can possibly cause paralysis only in a few rare cases. While most people with spondylolisthesis who receive proper treatment and follow rehabilitation program show an improvement, some people may experience paralysis as a complication due to damage to the nerves. Some studies have shown the possibility that sometimes isthmic spondylolisthesis, which is caused by a defect or a fracture can cause paralysis.(2) Hence is a major reason why people should seek professional treatment and diagnosis when possible. In a few cases, it may lead to severe spinal cord compression, a condition known as myelopathy. It may cause problems with performing simple tasks including holding objects, walking, fastening clothing, along with interference with bowel movement and control. The exact symptoms do vary depending on the spinal cord’s part that is affected. The underlying slippage of the spine should be addressed to prevent nerve damage as well as potential paralysis.(3)
If you are experiencing the symptoms of spondylolisthesis, it is important that to consult your doctor right away. As the early symptoms are backache, pain radiating to legs and bowel or bladder problems, these must be addressed at the earliest. Early measures of treatment can relieve most of its symptoms. Take appropriate treatment and precautions to prevent spondylolisthesis from getting worse with time and cause paralysis. Most people respond properly to conventional nonsurgical treatment. If you do not respond properly to medications or if your symptoms are persistent and severe, the doctor may advise you a surgery. However, due to its complications, make sure that you discuss it in detail with your surgeon before you decide to have surgery.