Spondylolisthesis
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Spondylolisthesis is the slippage of one vertebrae upon another. There are multiple "types" of slippage. The degenerative type is commonly seen in the elderly population and the "isthmic" type is commonly seen in the younger population.

In the degenerative "older" type, the patient usually has symptoms of spinal stenosis with increase chance of back pain. If the slippage is unstable, back pain becomes more significant.

The isthmic [younger] type of slippage is likely present from early adulthood; the patients tend to become symptomatic in their twenties or thirties.

Above, the 4th lumbar vertebra [white arrow] has slipped forward compared to the 5th lumbar vertebra [blue arrow]. This is an example of degenerative [older patients] type of slippage.

Both types of slippage respond well to physical therapy; epidural injections can also help calm the nerves down.

If the pain is not responsive to the therapy and injections, lumbar fusion surgery is the treatment of choice with good prognosis.

 
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