Pediatric Spondylolisthesis

Spondylolisthesis, another spinal deformity, occurs when one vertebra slips forward in relation to an adjacent vertebra (usually in the lumbar spine). In children, spondylolisthesis typically involves the fifth bone in the back or lumbar vertebra and the first bone in the pelvis or sacrum area. The condition is often caused by a birth defect in that region of the spine or a sudden injury.

The symptoms that accompany a spondylolisthesis include pain in the low back, thighs, and/or legs, muscle spasms, weakness, and/or tight hamstring muscles. Some people are symptom free and find the disorder exists when revealed on an X-ray. In advanced cases, the patient may appear swayback with a protruding abdomen; exhibit a shortened torso and waddling gait.

How and when is pediatric spondylolisthesis diagnosed?

The spine specialists at Midwest Orthopaedics at Rush will review the child's symptoms, conduct a physical exam and order X-rays of the child's spine. A Computerized Tomography (CT) and an MRI scan may also be used to assess the spine.

Patients often suffer low back pain and pain when the lumbar spine is extended. Hamstring tightness also occurs in many cases.

Who is likely to have pediatric spondylolisthesis?

Spondylolisthesis is much more common in children who participate in sports that require frequent or repeated hyperextension of the lumbar spine, such as gymnastics, wrestling, diving, weight lifting and football. The repetitive trauma can weaken the vertebra and cause slippage.

What is the treatment for pediatric spondylolisthesis?

Non-surgical Treatment

Treatment for spondylolisthesis depends on the severity of the vertebra slippage. Many patients improve by stretching and strengthening their lower back muscles.

Avoiding contact sports and activities that require hyperextension of the lumbar spine is recommended. The MOR specialists may suggest physical therapy as well as a back brace to limit the spine movement. They will schedule follow-up X-rays to ensure the patient's spondylolisthesis is not getting worse.

Surgical Treatment

In more severe cases, spondylolisthesis may require surgical intervention. Surgery is considered when neurological involvement exists or when conservative treatment has failed to provide relief from long-term back pain and other symptoms associated with spondylolisthesis. During surgery, the physicians at Midwest Orthopaedics at Rush will fuse the slipped vertebrae to make it properly aligned again.

What if the spondylolisthesis goes untreated?

If spondylolisthesis goes undetected or untreated, slippage continues and the vertebrae may begin to press on the nerves, causing infection, severe pain and/or even temporary or permanent damage to the spinal nerve roots, which may result in sensation changes, weakness or paralysis of the legs.