Spondylolisthesses treatment

Adults spondylolisthesses treatment

The treatment is usually conservative for the first stages of spondylolisthesis, with exercises to support the lumbar muscles, exercises to reduce lordosis and the application on a case-by-case basis of an anti-lord flexion guard.

In advanced stages the treatment is purely surgical with spinal fusion of O5 and I1.

Antilordotic Exercises

Simultaneously with the brace hould the patient be exercised daily in special antilordotic exercises that will teach him.

The exercises are specialized exercises and adapted to the capabilities of the patient and the severity of the disease and are done at any age.

Instructions for degenerative type spondylolisthesis 

Modification of activity

Patients can modify their activities to spend more time in a sitting position and less time standing up. The modification of activity generally includes:

• A short rest period Avoid standing and walking for long periods
• Avoid active exercise
  Avoid activities that require backward stretching.
• Application of heating pads
• Take appropriate painkillers after walking or any strenuous activity.

Static bike and heated pool is suitable sports activity

Exercises – Manual Therapy – Antilordotic brace

Many patients also benefit from controlled, gradual exercise and stretching as part of a physical therapy program to maintain and / or increase range of motion and flexibility, which in turn tends to relieve pain as well as help the patient maintain his ability to function in his daily activities.

A antilordotic brace, especially after exercise, standing and walking, can be very helpful in relieving pain.

Epidural injections

For patients with severe pain, especially pain in the legs, epidural steroid injections may be a reasonable treatment option.

The injections are effective to help fight pain and increasing function of the patient by up to 50% of cases.

If an epidural steroid injection works to relieve the patient’s pain, it can be done up to three times a year.

The length of time that lumbar epidural infusion can be effective is variable, as pain relief can last from a week to a year.

Surgery

Surgery for degenerative spondylolisthesis, rarely needed and most patients can manage their symptoms with the above non-surgical options.

Surgery can be considered if the patient’s pain is fixating on him and does not allow him to perform his daily activities. Surgery is also indicated if the patient is experiencing progressive neurological deterioration.

The goals of surgery are to re-align the affected part of the spine, to relieve pressure on the nerves and ensure stability in the area.