What is Cervical Spondylolisthesis?

Cervical Spondylolisthesis is a condition involving a vertebra in the spinal column that is not properly aligned with its neighbor. This allows it to slip around with movement, thus causing pressure on nerve roots and on the spinal cord itself. This condition can lead to neck pain as well as other symptoms.

Causes

Spondylolisthesis is most commonly detected in the lumbar region or lower back because that is the area which bears the greatest amount of stress. It is less common in the cervical or neck region. When it occurs, it is usually secondary to a neck injury, arthritis, infection, or degeneration of the cervical spine due to aging.

Some people with spondylolisthesis have a congenital defect in their cervical spine called spina bifida occulta. This is a condition where the vertebrae in the spinal column do not close completely, leaving small gaps in the bones. It is possible to have this congenital defect and not be aware of it.

Symptoms

Cervical spondylolisthesis characteristically causes neck pain and stiffness that radiates into the shoulders. If the slippage of the vertebra puts pressure on a nerve root exiting the spine or the spinal cord, it can cause numbness and tingling in the arms and hands as well as more serious symptoms. In severe cases, cervical spondylolisthesis can cause weakness, difficulty walking, or bowel/bladder incontinence.

Diagnosis

Cervical spine X-rays and MRIs are usually not adequate for making the diagnosis of cervical spondylolisthesis. These are static imaging techniques that only examine the spine from one position. The best way to look for abnormal slippage of a vertebra is by taking flexion-extension X-rays of the neck. This dynamic X-ray technique captures images of the neck while it is flexed and while it is extended, thus revealing any abnormal movement of the vertebra. A flexion-extension MRI of the cervical spine is another option.

Treatment

Mild cases of cervical spondylolisthesis may respond to conservative treatments such as anti-inflammatory medications, muscle relaxants, and physical therapy. An epidural steroid injection into the space around the spinal cord may be used to treat inflammation and relieve pain. More severe cases may require decompression and fusion to reduce pressure on nerves in the spine and increase spinal stability. Surgery may be required both anteriorly and posteriorly to provide adequate stability.

Tom Wascher M.D. will review your imaging studies free of charge or, if needed, provide you with a second opinion. He has performed over 1,800 cervical surgeries during his career and wants to see that you receive the best treatment possible. He is a competent and caring surgeon who has your best interests in mind.