I Have Read Alot About This Condition (Retrolisthesis) And I Was Diagnosed With This In L3 L4

Question

Asked by Bisaman

I Have Read Alot About This Condition (Retrolisthesis) And I Was Diagnosed With This In L3 L4

I wanted to know what other treatments there were for this condition (Retrolisthesis). My neurosurgeon advised against injections, therepy, and surgery at this time. Injections he stated "would not give long term relief. Therepy would or could make the problem worse and surgery would need to be done over a span of 6 plus surgeries and there was no guarantee that it would help. I have read alot and they all seem to be affecting the L4 L5 region and mine is in the L3 L4 region. Is there a different treatment for this area or would the treatment remain the same reguardless of where it was? The Dr. advised me at this time the best path to take is seeing a pain management Dr. I saw one and he wants me to do therepy which was advised against. Does anyone have any treatments they are doing that seem to be working? Thank you

Answer

Spondylolisthesis (either anterior or posterior or retro) is a common condition in the spine. As you read, the lumbar L4/5 is the most common area for a "spondy" in the lumbar spine, but a L3/4 "spondy" can also occur. The treatment is the same for all lumbar spondylolisthesis. Surgery is only recommended in for a severe (grade 3) spondy that is causing nerve damage. The pain associated with a lumbar spondylolisthesis will respond to physical therapy. Particularily, abdominal strengthening and tractioning in a prone (belly down position). Abdominal muscle strength is key to maintaining the stability of the lumbar spine and faulty segment. These muscle act like the built-in corsett. There are other smaller, local muscles that span the segments of the spine called the multifidi that also help to compensate for segmental instability (a spondy).

I highly recommend that you read a book by Rick Jemmett, PT called "Spinal Stabilization" (www.optp.com carries this book). This book has great pictures and explanations about the science of spine stabilization and what it can do to help you feel better. Remember, "spondylolithesis" is really a fancy name for spine instability (the bones don't line up). Despite what your surgeon says, the muscles can provide more stability for your spine. Connect with an expert in spine rehabilitation and leave the surgeon behind.

Dr. Christina Lasich, MD

Answered by Christina Lasich, MD