| "I actually have
'Spondy' as a result of having had a couple of back operations. Where
the spine goes into it's final turn at the base, my L5 vertebra is
being squeezed out by S1 and L4. It is the cause of most of my on
going problems but in the greater scheme of things it's not the worst
thing that could happen.
It was last looked at last year and x-rayed, but not problematic
enough for an operation. Everyone in the profession who I trust
advises building up the muscles around the spine through exercise.
I'm not qualified in anyway but if the problem is lower back then
lay on your back on the floor with your knees bent and your feet
flat on the floor about a foot and a half apart. Whatever is comfy
really. Because we don't usually use the muscles around the base
of our spines you will have to find them first. You can do this
by pushing your lower back into the floor. If you are using your
stomach muscles to do this you're doing it wrong. The muscles you
are trying to get going are further round the back.
The following extract is from espine.com
"Spondylolisthesis is defined as the movement of adjacent
vertebra relative to each other.
Although spondylolisthesis can be caused by many pathologic entities,
degenerative spondylolisthesis is by far the most common. With aging,
discs lose water content and ultimately height. As the vertebra
on either side of the disc come closer to each other through the
loss of disc height, the upper vertebra slides forward on the subadjacent
vertebra producing spondylolisthesis. High stresses and motion produce
degeneration of the disc and for this reason the most susceptible
levels of the lumbar spine, L4-L5, followed by L3-L4 and L5-S1 are
the vertebral segments most commonly involved.
Spondylolisthesis is also associated with deterioration of the
facet joints connecting the two vertebra. As the facet joints become
arthritic due to this deterioration, they enlarge in an attempt
to confer stability. As the two rings of the vertebral segments
which make up the spinal canal, slide past each other, the canal
narrows in size . The combination of canal narrowing and enlargement
of the facet joints, produces the characteristic nerve compression
problems found in degenerative spondylolisthesis. The nerves are
compressed in two major areas at the site of a degenerative sponlylothisis.
It is believed that a reduction in nerve blood flow accounts for
the symptoms produced from spinal canal narrowing (Spinal stenosis).
Extracted from A Patients
Guide to Low Back Pain
Symptoms
Spondylolysis and Spondylolisthesis are important because they
can be a cause of low back pain. Just because you have one
of these conditions, does not mean that you will necessarily ever
have problems with your back, but you are at a higher risk of developing
chronic low back pain than the normal population. These conditions
can cause typical mechanical back pain symptoms, or they
can cause compressive (or neurogenic) type symptoms - or
both. The mechanical symptoms
occur primarily because the spinal segment affected by the spondylolysis
is unstable resulting in segmental instability. The compressive
symptoms can arise because the nerves at the segment involved are
pinched. There is usually a lump of tissue in the area
of the spondylolysis - probably where the fracture tried to heal
itself. This lump of tissue may press on the nerve roots
as they leave the spine. The forward slip of the vertebra
also makes the spinal canal smaller, leaving less room for the nerve
roots.
There is usually pain across the small of the back and
into the buttocks. If there are compressive symptoms, there
may be pain down the leg to the foot, numbness in the foot and possibly
weakness in trying to raise the foot.
Diagnosis
The diagnosis of Spondylolysis and Spondylolisthesis is dependent
on seeing the abnormality on either X-rays, CAT scan or MRI scan.
In most cases it is easily seen on regular X-rays of the low back.
The symptoms are really no different from other causes of low back
pain. On the other hand, just because you have a Spondylolysis
or Spondylolisthesis on your X-ray doesn't mean your symptoms are
from the defect. You may still have a herniated disk or some
other condition that is causing your pain, so your doctor will carefully
look for other causes of your pain.
Treatment
Treatment for Spondylolysis and Spondylolisthesis is not really
much different than for other causes of mechanical and/or compressive
back pain. In most cases, surgery will not be necessary.
The mechanical symptoms that are a result of the segmental instability
can be reduced by strengthening the back muscles. A physical
therapist will probably be recommended to help you with a series
of exercises designed to help stabilize the spine by strengthening
the back and abdominal muscles. Medications may be used for
short periods of time to control pain, ease muscle spasm, and help
regain a normal sleep pattern if you are having trouble sleeping.
Short periods of bed rest may help with acute painful episodes.
A back brace, or corset, may reduce pain.
Surgery is necessary only if all of the above treatments fail to
keep your pain at a tolerable level. Surgical treatment for
Spondylolysis and Spondylolisthesis must address both the mechanical
symptoms and the compressive symptoms if they are present.
This usually means that the nerves that exit the spine must be freed
of all pressure and irritation. This is usually done by performing
a complete laminectomy. Laminectomy means remove the lamina.
Removing the lamina allows more room for the nerves, and enables
the surgeon to remove lump of tissue surrounding the spondylolysis
defect that is irritating the nerves. This allows more room
for the nerves of the spine and reduces the irritation and inflammation
on the nerves.
Once the nerves are freed, a spinal fusion is usually
performed to control the segmental instability.
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