Degenerative spondylolisthesis (DS) with spinal stenosis is one of the leading causes of lower back pain among people over 40 years old. The disorder is characterized by a displacement of one vertebra over the other, typically between the fourth and fifth lumbar vertebra of the spine, often leading to distinct signs and symptoms in other areas of the body. Although there are several subtypes of spondylolisthesis, this paper will focus on DS in light of its relevance to today’s maturing patient population.
Before discussing the idiosyncrasies of DS, it is important to denote the essential features of a normal, well-functioning spine. The normal spine is comprised of twenty-six bones, or vertebra, which are held together in vertical alignment with the help of muscles and ligaments. Each vertebra is sandwiched between discs of cartilage enabling smooth and cushioned movement of the body. The spinal cord descends through a central hole in these vertebrae and discs from the base brain to the lumbar region of the spine, where it then branches outward into multiple peripheral pathways which innervate the hips and legs. These nerves are responsible for transmitting signals back and forth between the brain and legs to control sensation, motion, and balance.
In DS, there is a progressive breakdown of the spine manifested in a …show more content…
Epidural injections also can be introduced around the base of the lumbar region, or cauda equina, resulting in reduced pain where nerve pathways branch out like a horse’s tail into the lower extremities (Walker, 2012). These injections may provide short-term pain relief, although longitudinal studies reveal less-promising effects over period of three years (Butterman, 2004; Cuckler, J., et. al., 1985; Fukusaki, et. al., 1998; Rosen, et. al,
Before discussing the idiosyncrasies of DS, it is important to denote the essential features of a normal, well-functioning spine. The normal spine is comprised of twenty-six bones, or vertebra, which are held together in vertical alignment with the help of muscles and ligaments. Each vertebra is sandwiched between discs of cartilage enabling smooth and cushioned movement of the body. The spinal cord descends through a central hole in these vertebrae and discs from the base brain to the lumbar region of the spine, where it then branches outward into multiple peripheral pathways which innervate the hips and legs. These nerves are responsible for transmitting signals back and forth between the brain and legs to control sensation, motion, and balance.
In DS, there is a progressive breakdown of the spine manifested in a …show more content…
Epidural injections also can be introduced around the base of the lumbar region, or cauda equina, resulting in reduced pain where nerve pathways branch out like a horse’s tail into the lower extremities (Walker, 2012). These injections may provide short-term pain relief, although longitudinal studies reveal less-promising effects over period of three years (Butterman, 2004; Cuckler, J., et. al., 1985; Fukusaki, et. al., 1998; Rosen, et. al,