When is a Spinal Fusion necessary to treat Spondylolisthesis in an adult ?

Spondylolisthesis describes a condition of forward slippage of one vertebrae in the spine over another. This conditions in adults is most commonly due to degeneration (wear and tear) of the discs and ligaments in the spine. Pain is most commonly the single symptom of this condition. Occasionally, numbness, tingling and weakness may also occur, particularly with activities. Sophisticated imaging such as MRI and CT scans will show “stenosis”, or a ‘pinched nerve in a narrow spinal canal’. One must realize that the imaging studies are obtained when the patient is lying down (supine) on the imaging table. However, most of the symptoms are aggravated by standing, walking and other activities. The treatment for spondylolisthesis must thus aim at not only decompressing the nerve, but more importantly at stabilizing the spine in an optimal position. A conservative treatment can be successful in mild conditions by using a brace and stabilization exercises. When failure of this treatment occurs surgical intervention may be necessary. When instability is significant then stabilization of the spine with a fusion may be essential to relieve pain and disability.

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