Lumbar shift, or spondylolisthesis in its medical term, is a forward slippage of one of the lumbar vertebrae over the other. The forward shift is called anterolisthesis. The situation where the upper vertebral bone slides backward relative to the lower one is referred to as retrolisthesis. Spondylolisthesis can lead to back and leg pain. It can often be treated with exercise and physical therapy, but sometimes surgery may be required.
What are the Symptoms of Waist Slip?
The symptoms of lumbar slippage vary. It does not cause any complaints in some people, while in others it can negatively affect life to such an extent that it prevents them from doing daily work. It can cause complaints such as continuous low back pain, stiffness in the waist and legs, tenderness in the waist region, pain in the thigh and leg, tension and contraction in the leg muscles, and limping in walking. In advanced lumbar slippage, symptoms of numbness, tingling, muscle weakness and decreased reflexes may occur in the leg.
What Causes Waist Slip?
It can be congenital or acquired. It can be seen at any age. The type seen in children is usually congenital. Rapid height growth in young people may be a risk factor. Injuries seen in sports such as football, weight lifting, gymnastics and athletics that cause excessive stretching of the waist can cause waist slippage. Before the slippage occurs, a crack usually occurs in the spine; this is called spondylolysis. When there is a crack in the backbone, the support that holds the spine in place weakens and this situation can turn into a slipped back after a while.
Lumbar slippage caused by a crack in the backbone is called isthmic spondylolisthesis. It most commonly occurs between the L5-S1 vertebrae.
Lumbar slippage that develops due to calcification in the facet joints at the back of the vertebrae or disc wear is called degenerative spondylolisthesis. Degenerative lumbar shift occurs most frequently at the L4-L5 level.
Congenital lumbar shift due to a defect in the structure of the facet joints is called dysplastic or congenital spondylolisthesis.
Sometimes, back slippage may develop as a complication of a previous back surgery.
Which Department is Go to for Waist Slip?
Patients with back and leg pain go to the physical therapy and rehabilitation department. Complaints that start as a result of acute trauma to the waist are referred to the orthopedics and traumatology or neurosurgery department.
How Is Back Slip Diagnosed?
Questioning the complaints and physical therapy is the first step in the diagnosis. Bone protrusions at the level of lumbar slippage may be a sign of stepping felt by touch. Lumbar slippage can be diagnosed with an X-ray. With the X-ray film, it can be understood whether there is a crack in the spine. Computed tomography or MRI (MR) imaging can be performed for a more detailed examination. Thus, it can be seen whether there are problems such as tumor, infection or lumbar canal narrowing that may cause similar complaints.
Spondylolisthesis is staged according to the severity of the slippage. If there is a slippage of less than 25% of a vertebral bone width, it is classified as stage I, if there is a slippage of 25-50%, as stage II, if there is a slippage of 50-75%, it is stage III, and if there is a slippage of 75-100%, it is classified as stage IV.
The treatment of lumbar slippage varies according to the degree of slip and pain. Especially in stage I, mild spondylolisthesis, the symptoms can be reduced with exercise and physical therapy and the bone can be helped to return to its normal place.
Flexion exercises and lumbar stabilization exercises are good for pain and limitation of movement due to low back slippage. After reducing the complaints with these exercises, it is aimed to return to normal life with flexibility, muscle strengthening and endurance exercises. During the recovery period in back slip due to sports injury, competitions that require double combat should be avoided. Recovery may take several weeks or months. In the painful period, the use of a waist corset may be recommended. Pain relievers may be prescribed. Epidural corticosteroid injections from the waist can reduce pain.
Non-surgical treatments are primarily preferred for waist slippage. However, in advanced (stage III and IV) lumbar slippage, an operation called spinal fusion, in which the spine is fixed with screws, may need to be performed.