Anterolisthesis refers to the atypical forward slippage of the vertebra. This usually causes pain in the lower back, but it may also affect the neck, arms, and legs. Doctors recommend anti-inflammatories, bed rest, and strengthening and exercise programs to help relieve pain.
Pain is often the first symptom of anterolisthesis, and it occurs due to the misaligned vertebrae pinching the nerves.
Doctors grade the types of anterolisthesis according to the degree of slippage.
This article discusses the causes, symptoms, and diagnosis of anterolisthesis. It also explores the treatments, recommended exercises, and prognosis of this condition.
Anterolisthesis is a type of spondylolisthesis, which occurs when one of the spine’s vertebrae slips out of position.
Anterolisthesis refers to anterior (forward) slippage of the vertebra. However, when a vertebra slips backward (posterior), doctors call the condition retrolisthesis.
Anterolisthesis is more common than retrolisthesis.
Anterolisthesis can often result from trauma due to sudden blunt force or fractures, perhaps from an accident or fall. The condition may also develop over time through strenuous physical exercise, such as bodybuilding.
A bone abnormality at birth may also cause the spine to slip forward.
Spondylosis of the upper (cervical) vertebrae affects more than 85% of people over 60. In turn, this may lead to anterolisthesis.
The symptoms of anterolisthesis will depend on the amount of slippage and the part of the spine where it occurred. Many people may also not realize they have the condition because it does not always cause symptoms.
Anterolisthesis can cause constant and severe
Mobility issues due to pain can lead to inactivity and weight gain. It can also cause a loss of bone density and muscle strength. There can also be an effect on flexibility in other areas of the body.
Other symptoms of anterolisthesis include:
- pain, numbness, or a tingling feeling spreading from the lower back down to the legs
- tight hamstring muscles
- stiffness or tenderness in back
- curvature of the spine
A doctor will diagnose anterolisthesis using a physical examination and an evaluation of the person’s symptoms. The examination will usually include a reflex check.
The next step after diagnosis is to establish the extent of the damage. Doctors use the following
- Grade 1: Less than 25% slippage.
- Grade 2: 25–50% slippage.
- Grade 3: 50–75% slippage.
- Grade 4: 75% or more slippage.
- Grade 5: Less than 100%(spondyloptosis)
Individuals with grade I or 2 slips are usually asymptomatic or mildly symptomatic, and treatment aims to alleviate pain and discomfort. Doctors consider people with higher grades of slippages as suitable candidates for surgery. However, they will also explore nonsurgical treatments first.
In other cases, they may inject steroids directly into the back to help reduce inflammation and ease the pain. They may also inject other affected areas of the spine, depending on the type of spondylolisthesis.
Physical therapy in combination with exercise programs may treat symptoms of anterolisthesis.
Rehabilitation for lumbar spondylolisthesis focuses on the muscles surrounding the lumbar spine. This type of treatment provides stability and may effectively reduce and prevent pain and instability.
A physical therapist may also recommend corrective exercise training that begins with gentle upper and lower body stretching. This training eventually progresses to an individualized core strengthening routine that gradually builds over time.
People should speak with their physical therapist to discuss a suitable training and exercise plan.
On rare occasions, doctors consider surgery as a last resort in treating anterolisthesis.
These procedures may be necessary for progressive slippage or if the pain persists despite other treatments.
Surgery may involve adjusting the vertebrae with plates, wires, rods, or screws.
Decompression is where doctors remove bone or other tissue to release pressure on the vertebrae and associated nerves.
Another option may be spinal fusion, which is when doctors transplant a piece of bone into the back of the spine, which heals and fuses together. This treatment creates a solid bone mass that helps stabilize the vertebra.
Doctors may recommend home remedies for people to help ease symptoms, alongside the above treatments.
Bed rest can help overcome mild cases of anterolisthesis. A physical therapist recommends rest for the first 4 weeks. Rest can also help prevent further slippage or damage to the vertebrae.
People should also stop participating in sports and strenuous daily activities until the pain subsides.
In other cases, doctors may recommend performing specific strengthening exercises. Exercise can increase pain-free movement, improve flexibility, and build strength in the back muscles.
Stabilization exercises can maintain mobility of the spine, strengthen the abdominal and back muscles, and minimize painful movement of the bones in the affected spine. Some examples of suitable exercises include pelvic tilts, knee lifts, and curl-ups.
Individuals may also potentially decrease the risk of anterolisthesis by:
- strengthening the back and abdominal muscles
- participating in sports, such as swimming and cycling, which minimize the risk of lower back injury
- maintaining a moderate weight to reduce stress on the lower back
- eating a well-balanced diet to help maintain bone strength
Above all, a person should consult a doctor or physical therapist about specific exercises for pain management.
Doctors generally do not recommend wearing a brace for anterolisthesis. However, if rest or activity restrictions do not reduce the pain, a brace may help stabilize the lower back and reduce pain.
For most people with low-grade anterolisthesis, back pain and other symptoms may improve with nonsurgical treatment.
Surgical approaches include fusion, reduction, and partial reduction. Although most