Spondylolisthesis Treatment

Spondylolisthesis is defined as slow anterior displacement of a vertebra at lower lumbar spine generally lower most vertebras L5 –S1.  Frequently occurs between the age of 10 -15 years.  Girls are more affected than boys.

Clinical Features Of Different Spondylolisthesis

 

True (Isthmic)

Congenital

Degenerative

Clinical Features

Asymptomatic or low back pain

Low backache pain, buttocks, feet, toes, thigh and legs.

Intermittent symptoms is common in elderly patients

 

History of trauma present in 50%. Common history of injury in adult and children

 

Five times more common in female

Deformity

Increase lumber lordosis

Stiffness of spine present

Pain in back, buttock or thigh

 

Palpable step L5 S1

Buttocks are flat

 
 

Torso is short

Scoliosis, pelvic waddle present

 
 

Transverse furrow at L5

Cannot bend beyond lower thigh

 
 

Sacrum is vertical

   
 

Buttock flat and hamstring tightness

   
 

Scoliosis in 13%

   

Neurology

L5 nerve root involved but rare

L5 S1

L5 rare, L3 L4 common

     

Neurological claudication present

 

Physiotherapy Measures

  • Rest
  • Bracing – children rigid brace or adult corset
  • Modalities – Short wave, Ultra Sound, Tens
  • Correct postural habits
  • Exercises – Mobility exercises, active posterior pelvic tilt, abdominal exercises, forward bending exercises, prone lying and repeated stretching of hamstring.