Spondylosis Specialist

What is spondylosis?

Slippage of a vertebra on another vertebra usually from a degenerative condition although it may be the result of a traumatic event or a congenital failure of fusion of the posterior elements of the vertebra

As the intervertebral disc ages with time, there is degeneration of the disc. The disc loses height and there can be some laxity in the posterior joints (facet joints). This can lead to abnormal motion, or slippage of one vertebra in relation to another. The vertebra can slip forward (anterolisthesis), backward (retrolisthesis), or to a side (lateral listhesis).  The slippage can decrease the space allowed for nerve roots in the central canal, lateral recess and foraminal stenosis and cause spinal stenosis. The most important aspect of spondylolisthesis treatment is to determine if the slippage (listhesis) is stable (moves within normal limits) or unstable (abnormal motion).

Spondylosis is related to aging and the wearing down of your bones and ligaments in your spine. That deterioration can lead to bone spurs and eventually, osteoarthritis. The disks degenerate and weaken over time, which can also lead to bulging disks and disk herniation.

Bulging disks and bone spurs often associated with spondylosis affect the facet joints, the holes in your spinal canal can narrow and pinch the nerves.

Common terms: subluxation, instability, anterolisthesis, retrolisthesis, listhesis

What are Symptoms of spondylosis: (similar to lumbar stenosis or cervical stenosis)

•Cramping, tight pain in muscles in lower back

•Feeling of instability or movement in back with bending

•Catching sensation in back

•Pinched nerves

What are the risk factors for spondylosis?

If you’ve endured a spinal injury, you’re more likely to develop spondylosis since they can push disks out of place. Arthritic conditions, such as osteoarthritis, make you more likely to suffer an injury. Bulging disks can lead to inflammation and sensitize the nerves, increasing your pain.

What are the treatment options for spondylosis?

Non-operative:

Medications (preferably anti-inflammatory medications) can help control pain,. Physical therapy can help strengthen musculature surrounding spine and improve stability.  Epidural steroid injections can help decrease inflammatory response and pain.

Operative:

Surgical treatment of spondylolisthesis is made after evaluating for instablility.

Stable spondylolisthesis:

The goal is decompression of the nerve(s) or root(s) affected. This can be done via a laminotomy/ foraminotomy.. Laminotomy/ foraminotomy is a minimally invasive technique removing the minimal amount of bone for visualization to ensure safe decompression of the nerve. Rarely, a laminectomy (complete removal of the back of the spine) is needed. However, a laminectomy has a higher rate of causing instability.

Unstable spondylolisthesis:

This will require a decompression (similar to stable spondylolisthesis) and fusion procedure with instrumentation.  The nerve roots will need to be decompressed but also the spine will need to be stabilized so that the abnormal motion can be stopped. This is usually performed with the addition of pedicle screw instrumentation.

•Minimally Invasive Surgery options

•Physical therapy and rehabilitative exercise

•Medications to reduce pain and inflammation

Dr. Nomoto offers minimally invasive surgery that can work wonders at providing long-term pain relief from spondylosis. The sooner you seek medical care and treatment, the better. Call or book your appointment with Dr. Nomoto to find out the right treatment method for you. There are treatments for spondylosis and ways to help stop or slow the progression. Be proactive with your health.