Alihan Derincek / Slipped Disc (Spondylolisthesis)

Spondylo means spine in Latin, and listhesis means slip. In other words, it is the displacement of the vertebrae forward or backward on each other. Since this slip is often in the lumbar region, it is commonly referred to as a 'lumbar slip'. More rarely, it can occur in the cervical vertebrae. Lumbar slip occurs in approximately 5-6% of men and 2-3% of women. It is more common in people who lift heavy weights, play gymnastics or American football, especially after high physical activity. It is more common in men than women, as men have higher levels of physical activity. Its incidence increases with the increase in physical activity at the age of 7-10 years in childhood.

Types of lumbar slip

Congenital lumbar sprain: It occurs due to congenital maldevelopment of the bone structures that hold the vertebrae in a suitable position with each other. So the connection between the two vertebrae is weak. Initially, it usually does not cause complaints, but it begins to show symptoms as the child's activity increases or reaches adulthood.

Acquired slip: It may occur due to calcification of the spine or after repetitive overloads.

What symptoms should be warning signs?

Many people can continue their lives without any complaints despite a slip in their lumbar. In other words, lumbar slip does not always show symptoms. It is often found by chance in films taken for other reasons. However, a few symptoms can be warning signs of low back pain.

Pain in the lumbar region after exercise
Hyperlordosis
Pain and/or weakness in one or both legs
Weakening of urination and defecation control
Deterioration of standing and walking in advanced lumbar slip (shaky walking).

Treatment

Medication: Depending on the severity of the pain, pain relievers and muscle relaxants are recommended. Drugs containing gabapentin are started in patients with nerve compression due to slippage and associated nerve pain. In very severe pain, narcotic painkillers are applied.

Exercise: Exercises that strengthen the abdominal, lumbar,and hip muscles are recommended.

Physical therapy: Treatments such as massage, cold/hot application, electrical application, and ultrasound can be applied.

Rest: It is often applied for 2-3 days when the pain is intense. Prolonged bed rest is not recommended.

Corset: Especially in painful periods, in patients with spinal fractures due to repetitive trauma (gymnastics), a corset can be used until the fracture heals or after

Surgical: There are 3 goals of surgical treatment: relieving the crushed nerve as a result of slippage, restoring the vertebra, and fixing the vertebra . In Spondilolistezis, it is aimed to fix the slipped vertebra in its correct place again and to secure in that position. Otherwise, both the symptoms cannot be regressed and the degree of slippage may increase. For this reason, screws and metal rods should be applied to fix the spine. This method increases the success of freezing by fixing the spine and has taken its place in modern treatment.