Lytic Spondylolisthesis

A stress fracture in the spine can lead to slippage of one vertebra on the next, leading to the development of back and leg pain, numbness in the legs and reduced mobility.

Overview

Crucial: the right treatment at the right time

Schoen Clinic specialise in the treatment of acute and chronic disc herniation (disc prolapse). Whether an exact diagnosis, conservative treatment or precise disc surgery – you will benefit from the experience of our spine specialists.

Cause & Symptoms

Lytic spondylolisthesis is caused by a stress fracture (pars defect) of the narrow bridge of bone between the facet joints at the back of the spine. There may be a hereditary aspect to this condition or certain sports, such as gymnastics, weight lifting, cricket and football can put a great deal of stress on the bones through constantly over-stretching the spine. Either can result in a stress fracture on one or both sides of the spine. 

Many people are not aware of their stress fracture or experience any problems for several years. However, over a period of time symptoms can occur including lower back pain and sciatic type pain in one or both legs. 

Over time a slippage or spondylolisthesis can develop and cause. The degree of spondylolisthesis may vary from mild to severe but if too much slippage occurs, the nerve roots can be stretched where they branch out of the spinal canal. This can cause pain, numbness, increased sensitivity or even weakness of the muscles, in the part of the leg where that particular nerve supplies. This is known as sciatica.

Diagnostics

Diagnosing lytic spondylolisthesis requires experience. There are many symptoms which are linked to the spondylolisthesis and the nerve compression meaning the condition can often be overlooked. With thorough diagnostic tests, we can find the cause of your problems and initiate the appropriate treatment.

Every diagnosis at Schoen Clinic begins with an extensive consultation and a thorough physical examination. After assessment we can confirm the diagnosis with imaging methods and precisely determine the level and extent of the spondylolisthesis and associated stenosis.

Lytic spondylolisthesis can be seen on an x-ray of the spine. Other tests such as magnetic resonance imaging (MRI) are required to look at the spine in more detail and to assess the degree of slippage and nerve compression. In this procedure, we can optimally visualise the spinal canal and the neural structures such as the spinal cord and nerve roots that pass through it. On occasions we may have to perform other tests such as a CT scan or neurophysiology testing.

Lytic Spondylolisthesis Treatment

Once we have diagnosed that you have a lytic spondylolisthesis we use various treatment methods, depending on the severity and the symptoms. Our consultants and therapists will develop an individual treatment plan for you. 

If the slippage is not yet very advanced, conservative measures such as physiotherapy can often help. The goal of our treatment programme is to relieve your pain significantly and improve your quality of life.

In some cases, spinal injections that can be performed as a day case procedure may be appropriate and can relieve some of the acute pain. 

For patients whose pain does not settle with conservative treatment, surgery may be necessary. The procedure will differ depending on the severity of the condition. For patients who do not have any slippage, surgery may involve directly repairing the stress fracture with a screw and bone graft. 

Patients where slippage (spondylolisthesis) occurs resulting in nerve pain (sciatica), surgery needs to address the sciatica as well as the instability of the spine. The nature of spinal surgery is not to ‘cure’ a condition but is aimed to provide benefit with a good percentage improvement and relief of symptoms. Good relief from back and leg symptoms following surgery usually occur in approximately 70% of cases. This is not necessarily felt immediately but over a period of time (often several months).

Aftercare

It is very normal to experience some level of discomfort/pain after the surgery. Our experienced nursing and medical staff will help you to control this with appropriate medication. The symptoms in your legs may fluctuate due to increased swelling around the nerves. This can take a few weeks to settle. It is important not to suddenly stop taking certain pain relief medication. Our ward physiotherapist will visit you after the operation to teach you exercises and help you out of bed. They will show you the correct way to move safely. Once you are confident and independently mobile, you will be encouraged to keep as mobile as possible.

Treatments are available at the following locations

Schoen Clinic London

Our Address
Schoen Clinic London
66 Wigmore Street
London W1U 2SB
General Telephone Enquiries
+44 (0)203 929 0801
Specialist Areas
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Specialists

Dr Philip Batty

Consultant Sport and Exercise Physician MB ChB, MRCGP, FFSEM

Back Pain Spinal Fracture 32 More ...
Back Pain Spinal Fracture Sciatica (with Herniated Disc) Scoliosis and Kyphosis 30 More ...
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Dr Roger Wolman

Consultant Rheumatology and Sport & Exercise Medicine MD (Res) FRCP FFSEM

Back Pain Sciatica (with Herniated Disc) 25 More ...
Back Pain Sciatica (with Herniated Disc) Scoliosis and Kyphosis Spinal Stenosis 23 More ...
Full Profile