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Spine Conditions

Degenerative Spondylolisthesis

Degenerative spondylolisthesis is a condition that leads to the slippage of one vertebra over the one below due to degenerative changes resulting in spinal stenosis (narrowing of the spinal canal). It is one of the most common causes of low back pain, affecting about 11.5% of the United States population.

Degenerative changes cause neurogenic claudication, a symptom commonly associated with spinal stenosis. Narrowing the spinal canal can compress the nerves traveling through the spine, particularly those that branch out from the spinal cord and travel into the lower back, buttocks, and legs.

Degenerative spondylolisthesis primarily affects the lumbar spine, though it can occur in the neck. It is common in people over the age of 50 and affects up to 15% of men and 50% of women aged 66-70 years due to hormonal changes in menopause. Sedentary work is an aggravating factor.

Age-related changes in the spine commonly cause degenerative spondylolisthesis. The main risk factors include:

  • Degenerative disc disease is the loss of disc elasticity and height that occurs as spinal discs dehydrate and become stiffer with age.
  • Arthritis of facet joints: Facet joints are small stabilizing joints located between and behind adjacent vertebrae in the spine. They help stabilize the spine, but facet joint arthritis can lead to instability and slippage.
  • Thickening and stiffening of the ligaments that stabilize the spine add further stress to the spinal structure.

These degenerative processes weaken the spine’s ability to maintain alignment and stability, particularly during movement, facilitating vertebral forward slip.

The symptoms of degenerative spondylolisthesis vary depending on the degree of the slip and the spinal nerves affected. Common symptoms include:

  • Lower back pain is the most common symptom. Pain may be exacerbated by activity and relieved by rest.
  • Neurogenic claudication is the second most common symptom. It involves pain, numbness, or weakness in the legs and buttocks that worsens with walking or standing and is relieved by sitting or bending forward.
  • Sciatica presents as radiating pain from the lower back down to the legs.
  • Tight hamstring muscles.
  • In severe cases, bowel or bladder changes may occur, requiring immediate medical attention.

Dr. Hieu Ball will review your medical history, assess your symptoms, and assess your level of physical activity. He will then perform a physical examination, including testing nerve function and mobility. He will also evaluate sensory disturbances, weakness, and tendon reflexes.

Imaging studies will include X-rays to assess spinal alignment and to view degenerative changes. An MRI scan will be ordered to provide detailed images of the spine’s soft tissues, including the discs, nerves, spinal ligaments, and spinal stenosis.

Contact Dr. Hieu Ball to schedule a consultation at his San Ramon. He offers a full range of treatments for neck pain. Dr. Ball offers state-of-the-art patient-centered care for patients with neck, mid-back, and low-back problems. He received his orthopedic and spine surgery residency and fellowship training at Harvard Medical School and UCLA-affiliated institutions. Education included training at Massachusetts General Hospital, Brigham and Women’s Hospital, and Boston Children’s Hospital. Dr. Ball is a double fellowship-trained orthopedic spine surgeon. He received a pediatric spine fellowship at Boston Children’s Hospital and a second adult spine fellowship at UCLA. Dr. Ball offers minimally invasive spine care, and many procedures often may be performed on an outpatient basis in an ambulatory surgical center setting.

References

  • Akkawi I, Zmerly H. Degenerative Spondylolisthesis: A Narrative Review. Acta Biomed. 2022 Jan 19;92(6):e2021313. doi: 10.23750/abm.v92i6.10526. PMID: 35075090; PMCID: PMC8823594.
  • Bydon M, Alvi MA, Goyal A. Degenerative Lumbar Spondylolisthesis: Definition, Natural History, Conservative Management, and Surgical Treatment. Neurosurg Clin N Am. 2019 Jul;30(3):299-304. doi: 10.1016/j.nec.2019.02.003. PMID: 31078230.
  • https://www.orthobullets.com/spine/2039/degenerative-spondylolisthesis
At a Glance

Dr. Hieu Ball

  • Double fellowship-trained orthopedic
  • Orthopedic surgery residency at Harvard Medical School
  • Over 20 years of spine surgery experience
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