Column A Thorough Explanation of the Causes of Spondylolisthesis and How To Prevent It: Why Is It So Common Among the Elderly?

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07.01.2025

What is spondylolisthesis ?

Lumbar spondylolisthesis is a condition in which the vertebrae have shifted from their normal position in the lumbar region.

There are two types of spondylolisthesis : “anterolisthesis”, in which the bone slips forward, and “retrolisthesis” in which the bone slips backward.

Two types of spondylolisthesis

Spondylolisthesis can be divided into two types: lumbar degenerative spondylolisthesis and lumbar spondylolisthesis.

“Lumbar degenerative spondylolisthesis” is a symptom of back pain caused by a lumbar vertebra shifting from its original position.

On the other hand, “lumbar spondylolisthesis” occurs when the strain on the misaligned spine causes cracks to appear on the projections on the back of the lumbar vertebra, causing instability on the totality of the lumbar vertebrae .

Symptoms of lumbar spondylolisthesis

Mild lumbar spondylolisthesis is often asymptomatic, and the patient may find that the lumbar spondylolisthesis has progressed only when symptoms begin to appear and he is finally examined by a specialist.

The main symptoms of lumbar spondylolisthesis are back pain, pain and numbness in the buttocks and lower limbs.

One of the most common symptoms of spondylolisthesis is numbness/pain in the buttocks and lower limbs that appears when walking. This is called intermittent claudication, a condition in which the patient is able to walk again after taking a short break.

Degenerative spondylolisthesis are often associated with spinal stenosis, and symptoms of stenosis, such as urinary problems, may also be present.

In the case of spondylolisthesis, pain may be intensified by movements that place starin on the misaligned area (e.g., when bending backward at the waist), and pain and numbness in the lower limbs may occur if there is pressure on the nerve roots in the misaligned area or other parts.

The origin of spondylolisthesis

For a long time, the cause of lumbar degenerative spondylolisthesis was deemed unknown, but recent studies suggest that intervertebral disc degeneration is a causal factor (*1).

*1 Source: I. Akkawi, H. Zmerly. Degenerative Spondylolisthesis: A Narrative Review. Acta Biomedica, vol. 92, No.6, 2021.

With the stress of daily life and the aging process, the intervertebral discs and other parts of the spine slowly degenerate, and as the disc degeneration progresses, the intervertebral joints and vertebral bodies also do, resulting in the lumbar spine shifting from its normal position. This is called lumbar degenerative spondylolisthesis.

The degenerative process, which begins with disc degeneration, may also involve trauma to the lumbar region and genetic factors.

The connection with age

As we age, the tissues that hold the lumbar spine in place, such as discs, ligaments, and joints, degenerate, and the lumbar spine loses stability as a result, resulting in spondylolisthesis. This is degenerative spondylolisthesis, which is more common in middle-aged people (40s or older).

On the other hand, spondylolisthesis occurs more frequently in young people (in their teens and 20s). The cause being that during adolescence, when the bones are still growing, people play sports continuously (athletics, gymnastics, soccer, etc.) that place a heavy strain on the lower back, resulting in fatigue fractures of the articular processes.

Muscle weakness and its connection to posture

Abdominal and back muscles are muscles that stabilize the lumbar spine. If muscle strength declines due to lack of exercise, etc., the stability of the lumbar spine will also decline, leading to spondylolisthesis.

In addition, poor posture, such as a stooped posture, puts extra strain on the lower back and leads to muscle weakness. This can also aggravate the spondylolisthesis.

How to prevent spondylolisthesis

Improving one’s posture

Simply being conscious of one’s posture on a daily basis can reduce the strain on the lumbar spine. Avoid postures such as hunching or slouching.

When standing, place your weight evenly on both feet, and when sitting, sit with your hips deeply into the seat so that your pelvis remains upright.

The habit of exercising

Muscle weakness leads to spondylolisthesis, so strength training can help prevent it. By strengthening your muscles, you can balance your muscles and reduce the strain on your back.

Our clinic’s treatments

The Cellgel Method

As mentioned above, the cause of spondylolisthesis is disc degeneration. Therefore, it is possible to repair degenerated intervertebral discs to prevent it and their progression.

With our Cellgel Method, a drug is injected that fills in the cracks in the disc, which then turns into a gel and repairs the cracks, thus providing a fundamental treatment. It is characterized by the fact that the volume of the disc is not reduced and the drug remains in the disc as a gel implant after treatment, thus preserving the disc.

Unlike conventional surgery, the CellGel procedure does not involve incisions, so there are fewer postoperative risks.

The hospitalization period is only half a day, and you can go home by yourself on the same day of treatment.

The Cellgel Method

The Florence and Q-Florence Method

The Florence Method and Q-Florence Method are performed to treat spinal canal stenosis.

The Florence and Q-Florence methods are minimally invasive, low-risk treatments for spinal canal stenosis.

Under partial anesthesia and sedation, a device is percutaneously inserted to widen the stenosed spinal canal.

The device is inserted to stabilize the vertebral body while preserving vertebral rotation and flexion, widening the spinal canal and reducing disc protrusion and ligamentum flavum thickening. Pain is eliminated by widening the narrowed spinal canal.

The Florence and Q-Florence methods are minimally invasive and low-risk procedures, and there have been no reports of post-treatment complications or recurrence of symptoms to date.