What is Spondylolisthesis?

Spondylolisthesis is the displacement of one vertebral body over the adjacent vertebral body that causes mechanical or radicular symptoms or pain. It can be idiopathic, acquired, or congenital.

Causes of spondylolisthesis:

  • Repetitive stress to the pars interarticularis, Traumatic accidental injuries, Microtrauma in sports, Pathological causes (such as Neoplasm, connective tissue disease, etc.), After laminectomy.

Sign & Symptoms:

  • Low back pain that can be similar to radiculopathy for lumbar spondylolisthesis, radiating neck pain for cervical spondylolisthesis, Pain is exacerbated with the extension of the affected segment, Tenderness on palpation of affected segment, Pain may improve in certain positions such as lying supine, Muscle atrophy and weakness, Hamstring spasm in case of lumbar spondylolisthesis, Poor Coordination and balancing, Walking difficulty.

Physiotherapy Management:

Exercise therapy:

  • Isometric and isokinetic exercises:
    • this will be beneficial for strengthening of the main muscles of the trunk, which stabilize the spine. this technique also helps in pain reduction.
  • Core Stability exercises:
    • planks and side planks,
    • crunches.
  • Movement in close-chain-kinematic & anti-lordotic movement:
  • Gait training:
  • Combination of Stretching and Strengthening exercises:
    • stretching of erector spine muscle,
    • gluteal and hamstring stretch,
  • Balance training:
    • sensorimotor training on unstable devices,
    • walking in all variations,
    • coordinative skills training.
  •  Hydrotherapy:
  • Muscle endurance training:
  • Cardiovascular exercises:
  • Williams flexion exercises:
    • the pelvic tilt, partial sit-ups,knee-to-chest, hamstring stretch, standing lunges, seated trunk flexion, and full squats.

Manual therapy:

  • Soft tissue mobilization:
    • Massage of iliopsoas and quadratus lumborum muscles, Lower back fascial massage, and Deep tissue massage.
  • Lumbar traction:
    • this can be done with a traction machine as well as manually.

Therapeutic modalities:

  • Hot and Cold therapies:
    • hot therapy helps in reducing muscle spasms and also helps in healing,
      • Heat can be administered through hot packs.
    • Cold therapy helps to reduce inflammation, muscle spasm, and pain.
      • Cryotherapy can be done with an ice pack, Cold spray, and Cryo-air therapy.
  • Combo therapy;
    • Combo therapy is the combination of therapeutic ultrasound and TENS.
      • TENS will stimulate your muscle, and reduce spasms, and pain.
      • Ultrasound increases blood circulation and helps reduce muscle spasms, cramping, swelling, stiffness, and pain.
  • Super inductive system (SIS).