Anterolisthesis is a spinal disorder characterized by a dislocation of at least one vertebra relative to another. It occurs when an upper vertebral body, the main part of a vertebra, slips forward relative to the vertebra below. As it moves out of position, it can pinch the spinal nerves connected to the vertebrae involved in the displacement, and also potentially damage the spinal cord. This condition is graded by severity on the basis of how far forward a vertebra has slipped.
Fractures are the most common reason for anterolisthesis, although there can be other causes as well. This condition is most commonly observed with the fourth and fifth lumbar vertebrae, although it can arise in other regions of the spine. Patients can experience a variety of symptoms, depending on the location and severity of the anterolisthesis. Some common signs are numbness, tingling, abnormal sensations, loss of bowel or bladder control, pain in the spine or in the region innervated by the involved nerves, and difficulty controlling the legs.
Medical imaging studies are used to visualize the spine. The displaced vertebrae will be clearly visible in the images and a physician can measure to determine the degree of displacement. This will be taken into account, along with the results of a patient interview, when developing a treatment plan. If the patient has a history of spinal injuries or other problems, a doctor may feel that conservative treatment will not be enough to address the problem.
Conservative treatments for anterolisthesis consist of rest and gentle physical therapy. The patient may be put on bed rest to allow the spine to recover without strain and the healing process can be extended. If the injury is severe, a doctor may recommend skipping this treatment and proceeding to surgical options such as spinal fusion, where the displaced vertebra will be moved back into place and fused to a neighbor to hold it in alignment. Spinal surgery will fix the abnormal positioning of the vertebrae although it can come with serious risks including the risk of infection or permanent nerve damage.
When diagnosed with anterolisthesis, patients may find it helpful to ask about the available treatments and to get information about the risks and benefits of each. The doctor can also discuss possible recovery time and other issues that may be important for the patient to know about. Patients should be aware that while surgery can reposition the vertebrae, symptoms like pain and neurological problems can sometimes persist.