Spondylolisthesis in the Lower Back: What Your Grade of Slippage Means
Spondylolisthesis in the lower back is a fairly common condition, although many individuals who have spondylolisthesis don't realize that vertebral slippage has occurred. Sometimes an asymptomatic patient learns about the condition after having an X-ray or other imaging scan for a completely unrelated reason.
Typically, before an official spondylolisthesis diagnosis can be made by a doctor, some form of diagnostic imaging must be performed, such as an X-ray, magnetic resonance imaging (MRI) scan, or computed tomography (CT) scan. These images allow a doctor to identify spondylolisthesis in the lower back by measuring how far one vertebra has slipped forward in relation to the vertebra below it.
The Meyerding grading system is frequently used in classifying the degree of vertebral slippage in a patientâ€™s lower back. The grading system is as follows:
- Grade 1 - up to 25 percent slippage
- Grade 2 - 26 to 50 percent slippage
- Grade 3 - 51 to 75 percent slippage
- Grade 4 - 76 to 100 percent slippage
- Grade 5 - An affected vertebra has slipped completed off the one below it
An individual with spondylolisthesis in the lower back may never experience symptoms, while another patient may have lower back pain, stiffness, and muscle spasms. Mid- to high-level slippage could cause a patient to walk with a waddle-like gait, exhibit extreme lordosis (abnormal inward curvature of the lumbar spine), and have a protruding abdomen. Additionally, should a slipped vertebra come in contact with the spinal cord or a nerve root, neurological symptoms of pain, numbness, tingling, and muscle weakness could affect the hips, buttocks, legs, and feet.
Unless mid- to high-level slippage is caused by a traumatic injury, surgery is seldom necessary to treat spondylolisthesis in the lower back. Conservative, nonsurgical methods such as pain medication, bracing, physical therapy, and low-impact exercise, among others, are usually the first treatments a doctor will recommend to a patient. Typically, several weeks or months of conservative therapy is able to alleviate symptoms.