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About New York Chiropractic and New York Spondylolisthesis

Introduction

You loved sports as a kid. You ran and jumped and wrestled with the best of them. Then you had an injury that may have slowed you down for a bit, but didn't quite stop you. Until a later time in your life, like now. 

Definition

Spondylisthesis is the forward slipping of one vertebra (See arrow.), usually L5, upon the one below.

Spondylolisthesis commonly occurs in combination with disc degeneration and spinal arthritis.

spondylolisthesis xray
xray of spondylolisthesis 
Description

 Graphic Animation of Spondylolisthesis

Spondylolisthesis takes on two forms: one with a fracture ("true") and one without a fracture ("pseudo").
"True spondylolisthesis"
  • the forward slippage of one vertebra on the vertebra below
  • caused by a stress fracture in the middle section of a vertebra called the pars interarticularis.
  • Such fractures occur typically between the ages of 7 to 10 years.  
  • This stress fracture is due to repeated stresses applied to a weakened area of bone by contact sports like football, hockey, injury, etc. As a matter of fact, it is reported that up to 30% of baseball players have spondylolisthesis. 
  • If you have true spondylolisthesis, you join the select group of 6% of people who have this condition.

"Pseudo-spondylolisthesis"

  • 25% of spondylolisthesis cases are not caused by the stress fracture as "true" spondylolisthesis cases are described.
  • Degenerative spondylolisthesis is a more apt term for this type of spondylolisthesis as it is caused by disc degeneration or other congential conditions such as facet asymmetry or elongated pars interarticularis.   
  • It occurs secondarily to facet arthritis and disc degeneration.
  • The L4-5 level is the most common level affected with L3 being the next.
  • More women than men are affected. 
  • It is mostly seen in people over 50 years of age.
  • Long-standing degenerative processes in the spine are the culprits, creating instability in the spine.
Examination

A thorough, clinical examination that may include imaging is important to your recovery.

 
 Lumbar Spine Exam Description
 
Treatment

In office, Dr. Gary Stefanick uses Cox Technic Flexion Distraction and Decompression to widen the canal space, drop the intradiscal pressure and increase the disc height to relieve pain.

You will welcome the Cox Technic manipulation that gently "pulls you apart," as many patients describe the treatment or say they need. Depending on the severity of your pain and symptoms, gentler Protocol I may be applied until 50% relief of pain or more restoring Protocol II may be applied to guide your recovery. 

 
 Graphic Animation of Cox Technic - Lumbar Spine
 This is an animation of the goal of Cox Technic Flexion-Distraction and Decompression: reduced irritation of spinal elements enough to relieve pain and help you regain your quality of life. The amount of decrease in size of the herniated disc necessary for pain relief varies from 0% to 100% for each individual patient.

 
 
Cox Technic  Protocol I - for severe pain and pain that extends below the knee
 
 
 Cox Technic Protocol II - for pain that is in the low back and leg but does not extend below the knee

In office adjunctive care may hasten your recovery.

Time to Heal

The 1000 cases study of low back pain patients showed that 95% of spondylolisthesis patients attained maximum improvement in less than 90 days and 90% needed less than 30 visits.

If you implement suggestions from Dr. Gary Stefanick to control spondylolisthesis' symptoms, it responds quite nicely to very gentle Cox Technic though it may take a few more visits than other conditions.

Interestingly, reducing the pain of spondylolisthesis varies inversely with the amount of force of the treatment, meaning that you may feel the doctor needs to use more pressure to treat you, but clinically it is found that the more gentle the flexion-distraction distraction treatment, the better the response of spondylolisthesis.

Special Considerations

Tight hamstrings are quite common in symptomatic spondylolisthesis cases. You will be shown special exercises to stretch your hamstrings. Flexible hamstrings allow you to flex and lift with less stress on your low back.

Comments

You may experience no pain with spondylolisthesis, but know that if you have slight pain in the low back or severe pain down the leg, your doctor using Cox Technic to adjust the spine and reduce the stress created by the slippage of the vertebra can help relieve your pain. Contact Dr. Gary Stefanick today.

At Home Care

At home you may want to avoid sitting for long periods of time, wear a support brace if recommended, take nutritional supplements that help rebuild disc cartilage, do exercises that strengthen your spine, sleep on a supportive mattress, sit in an ergonomically designed chair, and modify your daily activities as needed.

Clinical Case Reports and Outcomes: Spondylolisthesis

Contact Dr. Gary Stefanick about pain relief for your spondylolisthesis.

Reference
  1. Sakai, T; Sairyo, K; Suzue, N; Kosaka, H; Yasui, N: Incidence And Etiology Of Lumbar Spondylolysis: Review Of The Literature. Journal Of Orthopaedic Science 2010;15(3):281-288
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