Spondylolisthesis

Spondylolisthesis occurs when one vertebra slides forward, backward or to the side, relative to the one directly below it. This slippage can occur in the cervical, thoracic (much less commonly) or the lumbar spine, and is generally forward slippage, anterolisthesis. Retrolisthesis is backward slippage of the vertebra above, and lateral listhesis involves slippage to one side or the other. Regardless of the direction, spondylolisthesis is graded in one way: Grade I: 0 – 24.9% of the lower vertebra is uncovered, Grade II: 25 – 49.9%, Grade III 50 -74.9%, and Grade IV: 75% or more. Anterolisthesis and retrolisthesis can cause all the neurological symptoms of a herniated disc or spinal stenosis, because it can narrow the spinal canal nd also shrink the opening through which the nerve root leaves the spinal cord (neuroforamen). .Generally Grade I is painless, though there are exceptions when e.g., the facet joints are swollen from arthritis, or there is a bulging or herniated disc narrowing the opening in the spine through which nerve roots exits (neuroforamina). However even Grade I, and certainly higher grades can leave the intervertebral disc uncovered by the vertebra above, and this can lead to paraesthesias, numbness, pain and weakness, and even bowel or bladder symptoms in extreme cases. Most cases are traumatic in origin, but some authorities assert that it can be congenital, particularly when the bone connecting the facets to the vertebral body (the pars interarticularis) is fractured. Yoga is particularly useful in the most common type of spondylolisthesis, anterolistghesis. In general with anterolisthesis, the strategy is to move back the forward-slid vertebra. Abdominal strengthening and forward bending, making the spine as long as possible, are the poses that do this. Retrolisthesis is treated just the opposite way: strengthening the quadratus lumborum muscles, and doing back extension poses. Lateral listhesis is rarely symptomatic, although it makes the yogic treatment of scoliosis more difficult. See ‘scoliosis’ for details.