Spondylolisthesis (Cervical)

Spondylolisthesis occurs when one vertebra slips forward on the adjacent vertebrae.
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Symptoms

Conservative Treatments

About this Condition

Surgery

Anatomy

Symptoms
Neck pain that extends toward the shoulder, between the shoulder blades, and even pain in the
back of the head. There may also be radicular symptoms with pain, numbness, or weakness
extending into the arms or legs. If severe, loss of coordination and bowel or bladder incontinence
may occur.

About this Condition

Spondylolisthesis occurs when one vertebra slips forward on the adjacent vertebrae. This will
produce both a gradual deformity of the spine and also a narrowing of the vertebral canal. It is
often associated with pain.
[Source: Medtronic]
This content is for your general education only. See your doctor for a professional diagnosis and
to discuss an appropriate treatment plan.
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Conservative Treatments
Medication and Pain Management

The goal when prescribing medications should be maximum reduction of pain and discomfort
with minimal risk of overuse of the medications and avoiding side effects.

Non-steroidal anti-inflammatory medications (NSAIDs) include common over-the-counter drugs

such as aspirin, ibuprofen and naproxen among others. These drugs are potent long-term pain
reducers that work without concerns of dependence.
Opioid therapy to control chronic back pain is less ideal because of potential toxicity to the body
and physical and psychological dependence. Treatment by this class of drugs should generally be
a short term option when patients do not respond to alternatives.
Pain can often be reduced through the use of muscle relaxants, anti-seizure pain medications
such as Neurontin, Topamax, and Lyrica, anti-depressants, and oral steroids.
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Physical Therapy / Occupational Therapy

Physical and occupational therapy can play a vital role in your recovery. Once acute pain
improves, your doctor or a therapist can design a rehabilitation program to help prevent recurrent
injuries.
These programs often include heat, cold and electrotherapy to help alleviate pain, decrease
swelling, increase strength and promote healing. Methods include therapeutic exercise, manual
therapy, functional training and use of assistive devices and adaptive equipment to increase
strength, range of motion, endurance, wound healing and functional independence.
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Injections

In some cases, your doctor may give you an injection of a corticosteroid to help relieve your pain
and reduce inflammation. Corticosteroids mimic the effects of the hormones cortisone and
hydrocortisone, which are made by the outer layer (cortex) of your adrenal glands. When
prescribed in doses that exceed your natural levels, corticosteroids suppress inflammation, which
in turn relieves pressure and pain. They are most effective when used in conjunction with a
rehabilitation program. In addition, corticosteroids can cause serious side effects, so the number
of injections you can receive is limitedusually no more than three in one year.
A steroid is often combined with an anesthetic and injected into the area around the irritated
spinal nerves that are causing the pain. This area is called the epidural space, and it surrounds the
sheath-like protective membrane, or dura, that covers the spinal nerves and nerve roots. Steroids
reduce nerve irritation by inhibiting production of the proteins that cause inflammation. The
anesthetic blocks nerve conduction in the area where it's applied, numbing the sensation of pain.
An epidural spinal injection may be done either for diagnostic or therapeutic reasons. By
injecting medication around a specific nerve root, your doctor can determine if that particular
nerve root is the cause of the problem. When administered for therapeutic reasons, a spinal
epidural injection may provide long- or short-term relief, anywhere from a week to several

months. In some instances, an epidural spinal injection may break the cycle of inflammation and
provide permanent relief.
It's important to note, however, that an epidural spinal injection is typically not considered a cure
for symptoms associated with spinal compression. Rather, it's a treatment tool that a doctor can
use to help ease pain and discomfort as the underlying cause of the problem is being addressed
through a rehabilitative program such as physical therapy, or while the patient is considering
surgical treatment options.
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Surgery
METRx Microdiscectomy

A minimally invasive discectomy is an operation that involves using either endoscopic or

microscopic techniques to access and treat the spine. Only that portion of the herniated disc,
which is pinching one or more nerve roots, is removed. The term discectomy is derived from the
Latin words discus (flat, circular object or plate) and -ectomy (removal).
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METRx Minimally Invasive Hemilaminectomy

A hemilaminectomy is a spine surgery that involves removing part of one of the two laiminae on
a vertebra to relieve excess pressure on the spinal nerve(s) in the lumbar spine, or lower back. A
hemilaminectomy can be performed to relieve symptoms such as back pain and radiating leg
pain. A METRx hemilamectomy is a minimally invasive procedure performed utilizing METRx
technologies.
In a traditional open lumbar laminectomy the two laminae and spinous process of a vertebra are
removed to relieve excess pressure on the spinal nerves in the spine. The term laminectomy is
derived from the Latin words lamina (thin plate, sheet or layer), and -ectomy (removal). A
laminectomy removes or trims the lamina (roof) of the vertebrae to create space for the nerves
leaving the spine.
Anterior Cervical Discectomy with Fusion

Anterior cervical discectomy with fusion is an operation that involves relieving the pressure
placed on nerve roots, the spinal cord or both by a herniated disc or bone spurs.
Through a small incision made in a natural deep skin crease in the front of the neck, the surgeon:

Removes the intervertebral disc to access the compressed neural structures

Places a bone graft to fuse adjacent vertebrae

In some cases, implants a small metal plate to stabilize the spine while it heals

In certain cases, an artificial disc may be placed

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Open Laminectomy

Laminectomy is an operation that involves removing a portion of the bone over and/or around
the nerve roots to give them additional space. Your surgeon removes a portion of the lamina, the
bony rim around the spinal canal, if it is contributing to pressure on the spinal cord or nerve
roots.