Degenerative spondylolisthesis is the anterior slip of a lumbar vertebra. It may be due to bilateral (both sides) defect in the interarticular portion of the vertebra (spondylolysis).
Treatment of degenerative spondylolisthesis
-Most patients with symptomatic spondylolisthesis have good results without having to resort to a surgery.
-Patients should undergo nonsteroidal anti-inflammatory medication, but limited bed rest for acute or severe pain. Epidural steroids can provide temporary relief for patients with significant leg pain, but no lasting benefit has been shown. Those with predominant back pain may benefit from a lumbosacral corset.
-Once pain is controlled, a regimen of stretching, strengthening, and progressive exercise is indicated. Back flexion and isometric strengthening exercises are more effective than extension exercises in the rehabilitation.
-Consultation with a physical therapist is often beneficial during this phase, this is because some patients may benefit from additional treatment modalities such as heat, ultrasound, massage, and pelvic traction in addition to the teaching of effective stretching and strengthening exercises.
-Those patients in whom surgery is definitely not indicated may benefit from a formal back school.
-Overweight patients should be counseled as to the importance of weight loss to get good results with this type of therapy.
-A critical aspect of the nonoperative approach is patient education as to the nature and chronicity of their condition and the importance of following the recommended treatment plan.
-Compliance is often a function of education and motivation. Building an alliance with the patient will allow more sensitive issues to be addressed.
-The aforementioned nonoperative treatment should be undertaken in patients without indication for more urgent intervention; most specialists recommend a minimum of 3 months of non-operative treatment before considering surgery.
You might also want to read: Lumbar Decompression Surgery for Degenerative Spondylolisthesis
At the London Spine Unit, we have some of the best specialists to treat degenerative spondylolisthesis. Book an appointment to get a checkup.