Spondylolisthesis surgery is seldom necessary for the majority of patients dealing with the condition, which occurs when one vertebra slips forward and onto the vertebra below it. This form of spinal misalignment, which most often occurs in the lumbar spine, can lead to lower back pain, muscle spasms, tight hamstring muscles, an abnormal inward curve to the lower back, protruding abdomen, and a waddling gait. It's also possible that the spinal cord or nerve roots become compressed by a misaligned vertebra, which can lead to symptoms of radiating pain, weakness, numbness, and tingling in the hips, buttocks, legs, and feet.
Goals of Surgery
A doctor might recommend spondylolisthesis surgery for a patient who has not responded to conservative treatments, shows signs of progressive vertebral slippage, has debilitating nerve pain, or is exhibiting postural and gait abnormalities. As a result, a surgical procedure will aim to achieve one or more of these goals:
- Restore spinal alignment
- Stabilize affected vertebrae to prevent additional movement
- Relieve the pressure placed on the affected nerves
In severe cases with high degrees of slippage, fusion surgery may be recommended. Spinal fusion is a procedure that involves the installation of bone grafts, rods, and screws into the displaced vertebra and its adjacent vertebra. This permanently affixes the bones together and helps maintain spinal alignment. Sometimes, a laminectomy may be performed in conjunction with a fusion procedure to remove vertebral bone that is compressing the spinal cord or a nerve root.
Understanding the Risks
As with any surgical procedure, spondylolisthesis surgery has a number of associated risks that patients should be fully aware of before consenting to an operation. Risks include adverse reactions to general anesthesia, bleeding, infections, nerve damage, and rejection of hardware or bone grafts, if cadaver bone is used. Before making a final decision on surgery, patients should explore all of their surgical options, obtain additional medical opinions, and be 100 percent comfortable with the risks and benefits associated with a chosen procedure.