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Chiropractic and Lumbar Spondylolithesis

Definition: Anterolistheis (forward) movement of the vertebral body in relation to the spinal segment below. Whereas a spondylysis is term given to a stress fracture at the pars interarticularis (a certain area of the spinal segment). Spondyloptosis is a term given to the slipped vertebra (spinal bone) off the spinal bone below.

Pain Distribution: Low back pain, thigh and/or leg pain that radiates into buttocks.

Types based on Wiltse, Macnab & Newman classification

Type/Grades Name Definition
1 Dysplastic Congenital defect
2 Isthmic Lytic: stress fracture in pars

Elongated – elongated pars (no fracture)

Acute: fracture of pars

3 Degenerative Arthritis of lumbar spine
4 Traumatic Fracture of neural arch
5 Pathological Other patho, such as Mets, Pagets

Risk factors: Extension/flexion of the spine (flexion is often more painful than extension)

Treatments: Chiropractor Doctor’s goal is to reduce the load on the disc and facet joints, and try to increase the spinal canal space. Rest/ice during acute, and heat during chronic situations. Braces are often prescribed. Osseous manipulation or mobilization may be directed at the segments above and below, to improve biomechanics and decrease the stress on the unstable segments.

The doctor may also use conjunctive therapies such as acupuncture, stretches and massage and in severe cases/grading levels surgical intervention is recommended.

Lumbar Spine Disorders

Dr. Amrita Singh

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