Spondylolisthesis - Stress Fracture Treated by Expert Spine Doctors at Mercy

Spine Center at Mercy - Baltimore

The spine surgeons at The Maryland Spine Center at Mercy in Baltimore treat children and adults with all types of spondylolisthesis, including stress fracture and degenerative. Our renowned team of spine specialists draws on their years of innovative experience to offer patients advanced treatment options coupled with compassionate care.

About the Condition

Spondylolisthesis or slippage of the spine can be caused by a stress fracture in the lower back that occurred in childhood but never completely healed. This fracture is called spondylolysis. In most cases, this bone defect does not cause ongoing symptoms and is often unrecognized until later in life. The fracture produces weakness within the spinal column and in some cases leads to premature disc degeneration at the base of the spine. As the disc wears out, the fractured vertebra shifts forward out of alignment.

Typically, the slip occurs between the lowest lumbar vertebra (L5) and the sacrum, but can occur at other levels within the spine. The disc degeneration and associated arthritic changes often cause nerve compression and irritation.

NEXT: Symptoms & Diagnostic Process ›
Symptoms & Diagnostic Process

Adolescents or adults who had a stress fracture as a child can experience of the following spondylolisthesis symptoms:

  • Buttock and leg pain
  • Hamstring tightness
  • Physical deformity
  • Abnormal bowel and bladder function

In the worst cases, the lumbar spine dislocates over the front of the sacrum, a condition known as spondyloptosis (spine dislocation), causing patients to lose height between their rib cage and pelvis until their ribs rest upon their pelvis. Their rib cage projects in front of their pelvis, their buttocks are flattened, and they walk with a crouched posture.

NEXT: Treatment Options ›
Treatment Options

Treatment options for patients with spondylolisthesis include:

  • Intermittent bracing
  • Epidural steroid injections
  • Anti-inflammatory medications
  • Rest

Patients with persistent low back pain, nerve irritation and/or progression of the slip, require surgery in order to provide a more lasting relief and return to normal activities. When symptoms persist in children and young adults with stress fractures without vertebra shifting, a fracture repair procedure alone is often possible. For more cases with nerve compression and spondylolisthesis, a minimally invasive fusion procedure provides relief of the nerve compression and stabilization of the shifted vertebrae.

Our doctors have developed advanced surgical methods based upon stress relaxation to restore normal spinal alignment, trunk height, and body proportions. The preferred method of surgery is performed through one midline back incision. Anterior surgery (across the abdomen) is not required. Both fusion rates and spine biomechanics are enhanced by restoring the normal alignment of the spine. Clinical research with over 10-year follow-up has documented long-term clinical success with these procedures.