What is Spondylolysthesis (Lumbar Instability)?

Spondylolysthesis is a situation in which one or more vertebrae in Spine topple off or slip-off in respect to other vertebrae. This can happen either as forward displacement called as Antero-lysthesis, or as backward displacement called as Retro-lysthesis. This can happen anywhere along the spine, although the lower back is the most typical location (lumbar spine).
There are 3 main reasons for the occurrence of Lysthesis
Congenital – or by birth
Degenerative – with ageing
Traumatic – due to injury

As one can guess the first 2 categories are mostly stable as they develop over a period of time, giving body enough time to develop counter measures in reducing instability. So in such cases the patients usually do not develop any major symptoms and the diagnosis is an accidental finding on an X-ray. Small amount of back-pain can be managed with Physiotherapy, Core strengthening exercises, Medicines and occasionally Spinal Pain block injections.
Rarely congenital or degenerative types can develop symptoms by pulling the spinal nerves and causing Back-pain and leg pain specially on standing or walking, making the patient immobile or confined to home. In worse cases the pull on the spinal nerves may be so strong that it may disrupt the normal blood flow to the nerves and affect their functions. These patients start experiencing weakness in their legs, along with altered sensation like tingling or numbness and sometimes slipping of chappals or even loss of balance and falls. These individuals are the ideal candidates for surgical intervention. The displaced vertebra is surgically brought back to its normal position and is fixed with the normal vertebra below with the help of metallic screws and rods. This may sound scary but is a routinely done surgery and with the advancement of Endoscopically assisted techniques like UBE-TLIF is a relatively safe procedure, with faster recovery and early mobilisation.