Why does spondylolisthesis occur?

Spondylolisthesis occurs when one vertebra in the lower back slips over the one below it. This often involves a vertebra slipping forward relative to the one underneath.

The cause can be age-related changes in the discs and facet joints between the vertebrae. It could also be due to a defect or fracture in the pars interarticularis, often a genetically inherited condition. However, it can also result from traumatic loading either earlier in life or in adulthood. Sometimes, it's a combination of genetics and trauma, which explains why this spinal condition is common among certain elite athletes.

What are the symptoms?

The most common symptoms are lower back pain and pain that radiates into the buttocks and the back of the thighs. With more significant slippage, nerves may become pinched, which can cause numbness, sensory loss, and muscle weakness in the legs.

What treatments are available?

The initial treatment approach is physiotherapy and pain medication. If these are insufficient, a fusion surgery may be an option.

What can I expect from the results?

The desired and most common outcome after a fusion surgery is significant alleviation of back pain, which greatly improves your quality of life. Paradoxically, many patients experience increased mobility after a fusion surgery if the back pain has been reduced. The actual stiffness in the lower back is usually only perceived as a moderate limitation of movement freedom.

According to the Swedish National Quality Registry for Spinal Surgery, 70% of operated patients are "very satisfied" or "satisfied" with the outcome, 20% experience no improvement, and 5-10% report increased problems. Many patients also experience a continuous gradual improvement for 1-2 years after the surgery.

Are there any risks with a fusion surgery?

The most common risks are superficial wound infections treated with antibiotics. There is also a risk of damaging the membrane surrounding the nerves during the surgery, potentially causing leakage of spinal fluid. This is not a severe complication. The membrane is repaired, and the patient is required to rest in bed for a day.

A clear risk factor that you can influence is smoking. If you are a smoker, you have a higher risk of complications such as infection and impaired healing. Quitting smoking significantly increases your chances of a good treatment outcome.

How long is the hospital stay?

You are usually admitted for 1-2 days before you can go home.

How long will I need to be off work?

The speed of your recovery after surgery is individual and depends on several factors, including lifestyle choices such as smoking. The recommended period of sick leave is usually 2-3 months, depending on the type of work you do. You are often fully rehabilitated after 6-12 months.

What does rehabilitation involve?

Rehabilitation training after your surgery is crucial for achieving the best possible results and functionality. As an integral part of your treatment, we develop an individual rehabilitation plan tailored to your conditions. The goal is to restore full strength, functionality, and mobility, and increase your confidence in your back. This will provide you with the best conditions for a good quality of life and help prevent future problems. You are often fully rehabilitated after 6-12 months, after which we recommend that you continue wellness training to maintain the best possible back health. All physiotherapists at RKC have extensive experience in treating, diagnosing, and rehabilitating back conditions and pain.