Slipped Disc (Spondylolisthesis)
We’ll give your vertebrae back its support
Good news: most patients don’t experience any pain when a vertebra shuffles out of position. With a slipped vertebra (spondylolisthesis), one or more vertebrae in your spine slip. This is caused by a gap in the vertebral arches (spondylolysis). If the slipped vertebra doesn’t press against a nerve or directly against a disc, there won’t be any pain. However, chronic, deep-rooted pain in the lower back may also occur.
Specialists at Schoen Clinic will give your vertebrae back their support. We specialise in slipped vertebra treatment. From an accurate and thorough diagnosis, to non-surgical treatment, to precise surgery, you’ll benefit from the years of valuable experience of our back specialists. The result? Satisfied patients who don’t hesitate to recommend us to others.
Slipped Disc Symptoms
When the vertebrae come out of position
The vertebrae in your spine are fixed in position between the discs and held there by ligaments, tendons and muscles. In the case of a slipped vertebra, one or more vertebral bodies shift out of position, often in the lumbar spine region. They disappear from their original position, push forwards, drift back or turn away sideways. This alone doesn’t cause any pain. The deep-rooted back pain typically only occurs when vertebrae rub against each other, discs are squashed or nerves are pressed. This can lead to other ailments such as disc damages, slipped disc or osteochondrosis.
Slipped vertebrae are divided into four categories of severity:
- grade I: shifted less than 25%
- grade II: shifted 25% to 50%
- grade III: shifted 51% to 75%
- grade IV: shifted more than 75%
Causes: how does a slipped vertebra in the spine occur?
A slipped vertebra is either hereditary, caused by misalignments during childhood growth, or age-related, caused by wear and tear in the spine. As you get older, your spinal column segments become more and more unstable. Individual vertebrae are no longer held and can easily slip out of their existing position.
In some cases, a slipped vertebra can even occur due to overstraining of the spine in competitive sports. Gymnasts, pole vaulters and swimmers performing the butterfly stroke are at risk of this. Severe injuries of the spine can also greatly impair stability and cause the vertebrae to slip.
Slipped vertebra: symptoms are often invisible
More than half of those affected do not have any symptoms. Even patients with a hereditary slipped vertebra rarely report back pain. Your vertebra slides so slowly out of its natural position in the spine that the surrounding nerves and discs are rarely squashed. We only frequently observe severe back pain, especially after getting up, in patients with a slipped vertebra severity of more than 50% (grades III and IV). Pain will often increase during your everyday routine, for example, when lifting and carrying heavy loads. The mobility of the lumbar spine may decrease.
If a vertebra slips so suddenly that it clamps a nerve root, there will often be feelings of numbness in the arms or legs. A loss of control of bladder function and bowel movements, as well as sexual impairment, can also occur. In case of paralysis and functional disorders, seek a doctor immediately.
Diagnostics: how slipped vertebra is determined
Because a slipped vertebra can affect different regions of the spine, our diagnostics are fully and individually tailored to your requirements. At Schoen Clinic, we first examine the potential anomalies which support the initial suspicion of slipped vertebra in an initial consultation. These may include a pronounced hollow back, as well as palpable pain and a hardening of the back muscles. In severe cases, a stepwise formation between the spinal processes will be felt. In addition, weakness when bending the hips, stretching the knee or lifting and lowering the foot may be present. Paraesthesia in the upper or lower leg can also occur.
If our suspicions of slipped vertebra cannot be confirmed, modern imaging procedures such as x-rays and magnetic resonance imaging (MRI) are then included as part of the physical examination for comprehensive diagnostics.
Different procedures create security
With the help of x-ray examinations, slipped vertebrae and other changes in the spine can often be reliably detected. But for accurate clarification, we always recommend MRI. Using MRI, discs, nerve roots, ligaments and tendons can be presented. The suspicion of a narrowed nerve canal or pinched nerve can be significantly substantiated or disproved. Joint cysts or slipped discs can also be seen in the slice images.
As an alternative, x-rays can also be taken with a contrast agent (myelography), or a computer tomography (CT) can be conducted with a contrast agent (CT myelography).
If neurological abnormalities such as sensitivity disorders and signs of paralysis are observed, we also recommend a neurological examination. Using electromyography (EMG), we determine your nerve conduction speed using adhesive electrodes.
Slipped Disc Treatment
Slipped vertebra: treatment only following extensive diagnostics
If you have been diagnosed with a slipped vertebra, we consult with you to select the best-possible therapeutic approach. According to the severity and level of instability, this may involve conservative measures, but it could also involve surgical treatment. What’s important is applying the right treatment at the right time. Our experienced specialists and modern equipment offer the best basis for this.
Conservative treatment methods
Slipped vertebra treatment – without surgery where possible
90% of our patients are typically first treated using conservative methods at Schoen Clinic – in other words, without surgery. A key part of this is acute pain treatment using a combination of painkillers and muscle-relaxing medication. Afterwards, regular movement and muscle building exercises are crucial for a slipped vertebra. Exercises, both physiotherapy and back-focused, train your stomach and back muscles and keep the spine in shape.
We additionally recommend spine-friendly sports such as swimming on your back, cycling and Nordic walking. They even support muscle rebuilding. Changing to a healthy diet can also be beneficial. Each pound of weight lost reduces the strain on your back.
Surgical treatment methods
More support for the spine: surgical reinforcement
If conservative treatment doesn’t fully treat your symptoms, surgery may help. This is often the case when the slipped vertebra affects your nerve function or leads to spinal canal narrowing. Surgery is also recommended if back pain has been present for a long time or feelings of numbness have increased. If surgical reinforcement is required, you’ll be in safe hands with us. Our experts are some of the leading specialists in spinal surgery and are setting medical benchmarks in this area.
Our preferred surgical method for slipped vertebrae is biological reinforcement, whereby we move your slipped disc back to its starting position using a screw-rod system and screw it onto an adjacent disc. Although this will cause the spine to lose mobility in this area, it will be more stable. Because just using the screw-rod procedure alone could loosen the slipped disc, we place a supporting titanium or plastic cage between your vertebrae. This is then filled with material from your bones or a bone substitute. This helps us stabilise the affected area of the spine.
After surgery, we recommend immobilising your back for twelve weeks. During this time, our patients wear a stabilising corset. This way, we can ensure that the implanted foreign body becomes stable. After this corset has been removed in stages, you can begin physiotherapy. Step-by-step, you’ll then be fit and healthy again for your daily routine.