Hi, I’m Dr. John Shim, and I’d like to
discuss how to treat spondylolisthesis. I’m sure you’ve seen
my prior video on what is spondylolisthesis. This is the follow up
on how to treat it. First, let’s all understand that 6% of
the human population actually has spondylolisthesis. Just because you have
spondylolisthesis identified on your studies does not mean it necessarily
causes pain, but there are three main types of spondylolisthesis. Number one is
congenital. Some people are just born with the rings slipped forward onto one
another. The second form, or number two, is
traumatic. It can develop either through a repetitive stress or through a trauma. To give you an example, young gymnasts who have to extend their back during
their training can develop spondylolisthesis by the repetitive
stress on that part of the bone. Football linemen secondary to the forces applied
to their lower back when blocking can develop these stress fractures related
to the blocking to their lower back causing spondylolisthesis. The third type
of spondylolisthesis is degenerative. Over time as a ligament stretches and
the discs lose its competency you can develop spondylolisthesis. Treatments are dependent on your complaints. For young athletes, if it is a repetitive stress
type problem, it can cause pain, it can cause difficulty with activities and
competition. After testing if you find spondylolisthesis initial treatments
should include rest, avoiding certain activities, and sometimes using a brace. If the stress fracture heals, you can get back to your normal activities. If you
have more significant spondylolisthesis type complaints of pain, the stress
fracture doesn’t heal, the bones start slipping further, you may actually need
to have surgical management, but before you do that make sure you have a good
evaluation by a surgeon to decide your options is typically a fusion operation. For older people who developed degenerative spondylolisthesis, it
typically causes a pinched nerve sensation resulting in radiating
symptoms to the legs. Like all pinched nerves, therapies can be helpful,
medications can be helpful, and injections can be helpful. Ultimately, if the
pain does not improve and becomes intolerable, then we can discuss surgical
options. Which there are many. There are some that requires fusions, there are
some that require non-fusion techniques. Having said that, most cases of spondylolisthesis and these stress fractures related to spondylolisthesis can be
treated without surgery. As stated before, 6% of the human
population has this. The vast majority of people do not even know that they have
the spondylolisthesis conditions in the lower back. If a test show
spondylolisthesis, please get an evaluation to see if that finding is
even the source of the pain. Many times that pain is the normal sprain and
strain of a back that we experienced through daily life. Its not the spondylolisthesis
causing the pain. So, don’t be scared if you were told you have this finding. Just
have it evaluated, and make sure that the problem is not something that requires
more aggressive treatments. Thank you for listening. If you’d like more information
about similar topics, please subscribe to our newsletter or to our YouTube channel.
Thank You.

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