Lumbar spondylolisthesis is one of the most common conditions affecting the spine. It causes severe pain that impacts patients’ quality of life. This slippage occurs when a vertebra in the lower part of the spine moves out of its natural position, leading to pressure on nearby nerves and varying degrees of pain that may radiate to the lower limbs.
Treating lumbar spondylolisthesis in Turkey is an ideal option for many patients worldwide due to the availability of modern medical technology, specialized expertise, and more affordable costs compared to other countries. In this article, we will explore the details of lumbar spondylolisthesis, its symptoms, and the latest treatment options available in Turkey while highlighting the advantages that make Turkey a leading destination for treating this medical condition.
An overview of lumbar spondylolisthesis
Pain from spondylolisthesis is one of the most distressing forms of discomfort, as it severely limits a person’s movement and prevents them from performing many daily tasks. Sometimes, the patient may be unable to walk.
Lumbar spondylolisthesis can be treated using various methods, including surgical and non-surgical approaches. Treatment choice depends on the degree of vertebral slippage and the severity of the symptoms.
In Turkey, the procedure to relieve pressure on the nerves is performed to alleviate the symptoms of lumbar spondylolisthesis. It is accompanied by spinal fusion surgery to ensure these symptoms do not recur. Contact us for more details on treatment options in Turkey.
What is a lumbar spondylolisthesis?
The spinal column consists of bony segments called vertebrae, which are stacked on top of each other and held firmly in place by ligaments and muscles. Between each pair of vertebrae, there is a cushion-like disc made of cartilage to reduce friction.
The stacked vertebrae form a tunnel where the spinal cord resides, and the nerve roots responsible for sensation and movement in the trunk and upper and lower limbs exit from this tunnel.
Spondylolisthesis occurs when the vertebrae are misaligned. This causes one to shift forward and compress the spinal cord that passes through the spinal canal.
This condition can cause sensory and motor symptoms based on the affected nerve root, often leading to inflammation in the affected nerve area, such as the neck.
The most common site for spondylolisthesis is the lower back, known as spondylolisthesis of the lumbar region. This is more common than cervical spondylolisthesis. The fifth lumbar vertebra is typically the most affected above the sacral vertebrae.
The nerves that exit at this spinal column level are responsible for the lower limbs. Therefore, lower back pain and pain in the posterior thighs are the most common symptoms.
Causes of lumbar spondylolisthesis
Lumbar spondylolisthesis occurs in anyone, but the risk of experiencing a slipped vertebra increases in the following individuals:
- Young athletes, especially those who engage in excessive stretching exercises or participate in sports that put significant pressure on the spinal column, such as gymnastics. These sports can cause repeated minor injuries to the lumbar vertebrae, eventually leading to cracks and fractures, resulting in the vertebrae slipping out of its position.
- Genetics: Individuals vary in the thickness of the bone forming the vertebrae. Some people have thinner vertebrae that are more prone to fractures, degeneration, or herniation, especially when combined with increased weight.
- Aging: Spondylolisthesis commonly occurs with advancing age due to bone wear and tear, decreased strength, and osteoporosis. This makes the vertebrae more susceptible to fractures and instability, particularly in the spinal column.
Symptoms of spondylolisthesis
A person may have lumbar disc herniation without realizing it because it is sometimes asymptomatic. The symptoms of lumbar disc herniation in susceptible individuals include:
- Severe pain in the lower back that worsens with walking and standing but improves with rest and slight forward bending.
- Radiating pain to the buttocks, pelvis, coccyx, and thighs.
- Acute stiffness extends to the muscles of the lower back and thighs from behind.
- Numbness, tingling, and weakness in the lower limbs due to compression of the lumbar nerve roots.
Note: It is important to differentiate between Spondylolisthesis (slipped vertebra) and a slipped disc (herniated nucleus pulposus). The former, as mentioned earlier, is a misalignment of the vertebrae on top of each other. The latter refers to the displacement of the disc between the vertebrae, pressing on the spinal cord. It may cause symptoms similar to lumbar disc herniation, but it tends to have unilateral symptoms, leading to a condition commonly known as sciatica.
The diagnosis of spondylolisthesis
The diagnosis of spondylolisthesis begins with the patient’s symptoms and a clinical examination, where we can determine if the nerve is compressed at any point along its course.
Suppose there is suspicion of lumbar disc herniation. In that case, we then resort to radiological methods such as X-ray imaging of the spine and axial tomography or magnetic resonance imaging (MRI) to determine if the herniation is of vertebral or disc origin.
Degrees of lumbar spondylolisthesis
Lumbar spondylolisthesis is classified according to the severity of the disc displacement and the degree of compression of the adjacent nerve structures. This determines the type of treatment needed for the patient.
Lumbar spondylolisthesis treatment
The treatment depends on the patient’s symptoms and the severity of the condition. It is divided into non-surgical treatment, initially attempted, and surgical treatment, considered in advanced cases.
Non-surgical treatment of spondylolisthesis
Patients with mild to moderate lower back pain symptoms receive non-surgical treatment. These treatments may benefit them, and their pain may significantly decrease. In such cases, there is no need for surgery.
Non-surgical treatment includes:
- Rest: It is considered one of the most important pain relievers for lower back pain. Increased movement and exercise can worsen the condition and cause problems.
- Pain killers: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are commonly used.
- Physical therapy: Also known as physiotherapy, physical therapy involves specific exercises aimed at strengthening the muscles and helping to alleviate symptoms. It is done under the supervision of a specialized physiotherapist. Highly skilled physiotherapists are available in Turkey.
- Wearing braces: A brace helps stabilize and immobilize the back, allowing fractured or broken bones to heal and improving the patient’s symptoms.
- Local steroid injections: In some cases, a specialized doctor injects cortisone locally at the site of back pain to help alleviate lower back pain.
Surgical treatment of spondylolisthesis in Turkey
Surgical intervention is considered for the treatment of lumbar spondylolisthesis in the advanced stages of the condition. Surgery in Turkey has satisfactory results for patients in terms of symptom relief and alleviation of lower back pain.
To consider surgical intervention, one of the following must be met:
- Severe pain occurring in the lower back due to Spondylolisthesis that does not improve with non-surgical treatments.
- Severe degree of spinal herniation.
- Progression and worsening of the condition necessitate surgical intervention.
There are two types of surgeries for the treatment of Spondylolisthesis to relieve lower back pain: decompression surgery and spinal stabilization surgery. One or both of these surgeries may be performed at the same time.
Decompression surgery in Turkey
This surgery involves removing a portion of the vertebrae that is compressing the spinal cord or nerve root, leading to the resolution of symptoms and significant improvement in the patient’s condition and lower back pain.
This surgery may be insufficient and incomplete, so it should be accompanied by spinal stabilization surgery to achieve greater patient satisfaction. They are performed together in the same surgical procedure.
Spinal stabilization surgery in Turkey
This surgery involves stabilizing the slipped vertebra by using metal implants or screws to keep it in place and prevent movement. It provides significant relief for patients after it is performed, but it may cause some restriction of back movement due to the stabilization that has been done.
Stabilization is initially achieved by placing metal pieces that connect the vertebrae to each other and a bone graft between them to facilitate healing based on the same principle as fracture healing.
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