Anterolisthesis is the medical term for what is commonly called spondylolisthesis. It is a condition of the spine wherein the drum-shaped area upper section of vertebra that is present anterior to each vertebrae slips ahead onto the vertebra located below. The associated symptoms differ a great deal from one patient to another; it is dependent on the region affected by the slippage and whether or not the slippage causes pinching or constriction of nerve roots.
The percentage of slippage of upper vertebral area is graded on a 1 to 4 scale, with less than 25 percent slippage being graded as mild or Grade 1 and over 25 percent slippage being graded as severe or Grade 4.
Symptoms of anterolisthesis
Some of the signs and symptoms of anterolisthesis are listed below:
- Pain in lower back: It is one of the most common symptoms of anterolisthesis.
- Pain may be widespread or localized. Patients may experience severe pain at the area affected by slippage. Pain tends to keep deteriorating due to muscle spasms as the body tries to guard itself. The spasms will cause muscular tightening which can then trigger extreme pain and inflammation of tissues present near the spine, disc, and/or nerve roots. The process will eventually lead to increased painful episodes, thereby generating an almost constant cycle of pain that keeps increasing in severity levels.
- Sometimes, patients may suffer from pain in one or both their legs. This may occur along with numbness and/or weakness. Muscle weakness in anterolisthesis patients is often an indication of severe underlying damage of nerves.
- Loss of bowel or bladder control: People with anterolisthesis that occurs at the lumbar or lower back area of the vertebral column and affects cauda equina nerve roots may suffer from symptoms like loss of ability or difficulties in elimination and retention functions of the bowel and/or bladder.
- Walking problems: Movement is restricted due to increased pain. When the pain radiates to the legs, then the patient may find it difficult to maintain balance or walk.
- Restricted movements of body: The intensity and spread of pain and inflammation in the back, legs, and/or buttocks may prevent the full range of motion when twisting, bending, etc.
- Other symptoms: Patients may uncommonly experience loss of ability to control the legs, tingling, and other anomalous sensations.
Anterolisthesis Grades
After the diagnostic tests are over, the degree, severity, and extent of anterolisthesis is rated or graded as a percentage of vertebral slippage. The different grades of anterolisthesis are listed below:
- Grade I: There is 25 percent forward displacement/slippage. It is regarded as mild
- Grade II: There is 26 to 50 percent forward displacement
- Grade III: There is 51 to 75 percent forward displacement
- Grade IV: There is 76 to 100 percent forward displacement. It is regarded as being a very serious case of anterolisthesis.
- Grade V: The upper vertebral section falls off completely from the adjacent vertebra
Causes
- Anterolisthesis can occur due to spinal injuries or excessively forceful impact on the vertebral column or the C5 and C4 vertebrae. These can be caused by motor accidents, falls from great heights, or sporting injuries. In serious cases, forward slippage of vertebrae may occur along with fracture or breakage of other bones that are present near the spinal cord.
- If sudden forceful impact is not the cause of anterolisthesis, then it may occur due to:
- Genetics
- Performing strenuous physical activities like playing football, weight lifting, or gymnastics. Hence, sportspersons and athletes are at greater risk to anterolisthesis. Also, more men engage in vigorous physical work and are thus more vulnerable to forward displacement of vertebrae.
- Ageing process may be marked by degeneration of different bones in body. This can make them more fragile and increase risk of fractures, injuries, or damage. Thus, the elderly are more vulnerable to developing anterolisthesis.
- Tumors in spinal cord
- Instability, core/foundational weakness, or poor posture. These factors may eventually result in mechanical collapse of the vertebral segment or degenerative anterolisthesis alterations.
Treatment of anterolisthesis
Anterolisthesis treatment involves the following options:
- Rest, without causative physical activities, is advised for mild cases of anterolisthesis. Rest allows natural healing of body as well as alleviation of pain and inflammation.
- Medications like non-steroidal anti-inflammatory drugs for easing pain. Opioid therapy may be used for relief from chronic back pain. Other medicines for vertebrae slippage include anti-seizure pain meds, muscle relaxants, oral steroids, and antidepressants.
- Physical rehabilitation therapy by a trained and qualified physical therapist for reducing inflammation, easing pain, and enhancing vitality. The therapy also helps increase core strength, i.e., build up the muscles of the back and abdomen. The therapist may also opt for electrotherapy, heat compresses, and therapeutic exercises to promote recovery.
- Depending on respective medical history and other factors, patients may also be given chiropractic treatment.
- Surgery may be done with focus on removing tissue and bone to alleviate pressure on spine and/or fusing the bones into their correct position.
