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What is Anterolisthesis?

The front drum-shaped area of the vertebrae is known as the vertebral body. Whenever it “slips” forward, it’s called anterolisthesis.

We can grade the slippage based on severity. Specifically, we can use a scale from 1 to 4. “Ante” is Latin for front, while “listhesis” is Greek for sliding down a slippery path.

Understanding the origins of these two terms will help you remember this medical condition.

Vertebral Anatomy

The vertebrae are the bones that make up the spine. Each vertebra (singular) has a small hole which the spinal cord passes through.

They stack up on each other like pancakes, with the thicker vertebrae towards the bottom. There are three types:

  • Cervical (Top)
  • Thoracic (Middle)
  • Lumbar (Bottom)

Between each vertebra is an intervertebral disc. These discs serve as a type of cushion that can absorb shock. They also help protect the spinal cord.

In people with anterolisthesis, the upper vertebral bodies are abnormally position compared to the lower ones.

Specifically, they “slip” forwards, which can lead to pain and muscle spasms. Here’s a video of a patient with this spinal condition:

The Anterolisthesis Severity Scale

anterolisthesis

As we mentioned, a scale from 1 to 4 is used to calculate the “magnitude of slippage”. For example:

  • In grade 1, there’s a slippage of <25%.
  • In grade 2, there’s a slippage of >25%.
  • In grade 3, there’s a slippage of >50%.
  • In grade 4, there’s a slippage of >75%.

The higher the grade, the worse the slippage. It’s a relatively simple system to follow.

As slipping becomes worse, it can put pressure on surrounding nerves. This can lead to pain as well as muscle spasms.

Some patients with anterolisthesis may also experience mild leg numbness. In many cases, it’s due to physical trauma. Chronic poor posture can also be the cause.

Bottom Line:  There are four grades to this spinal condition- 1, 2, 3, and 4. The higher you go, the worse the symptoms will be.

What Causes Anterolisthesis?

A hard impact to the spinal cord can cause anterolisthesis. This can be due to a fall, a car accident, or a sporting accident.

Athletes who play high-collision sports (rugby, football, etc.) are at a higher risk. It’s common in older people since they fall a lot, though young people can get it too.

Poor posture can also be the cause. If you sit at a desk all day, you’ve got a higher risk of spinal problems.

Therefore, it’s important to use good form whenever you’re sitting and sleeping.

Bottom Line: Physical trauma (falls, car accidents, etc.) and poor posture are the main causes of this spinal condition. Older people should be careful about falling.

Symptoms of Anterolisthesis

The degree of slippage plays a big role in how severe the symptoms are. The main symptom is pain.

As the vertebral bodies slip forward, it can compress nearby nerves. Depending on which nerves get affected, the pain can be localized or widespread.

Another common symptom is muscle spasms. Again, this due to the nerve compression taking place.

Some patients also experience leg numbness which may or may not be accompanied by weakness. Although rare, it’s also possible to experience an inability to pass urine.

There’s no doubt that these symptoms can ruin your quality of life.

Bottom Line: People with this spinal condition can experience pain, muscle spasms, and leg numbness. In rare cases, they won’t be able to pass urine.

Treatment Options

In general, there are three primary treatment options for anterolisthesis:

Rest

Reserved for milder cases of this spinal condition. Your doctor may recommend avoiding all physical activity for several days to several weeks (or longer).

This treatment option costs nothing and can be effective for low grade cases. Depending on your age, you may spend this “rest phase” at home or at the hospital.

Most older people generally spend it at the hospital so they can get help using the bathroom.

Physical Therapy

Most of the time, physical therapy will be given in part with rest. A physical therapist can help move your vertebral bodies back into place, thus, lessening the amount of pain you feel.

Therapy sessions may involve massages, electric stimulation, postural training, and more.

Note that these are all non-invasive procedures that are aimed to help treat your condition. Pain medication may also be given.

Surgery

Designated for the most severe cases. In interbody fusion surgery, the surgeon will make a small incision in hopes of reducing spinal slippage.

This is a relatively common surgical procedure that comes with a low risk of death.

Keep in mind that, as with any surgery, there’s always the risk that you can damage a nearby nerve or blood vessel. If you have concerns, speak with your surgeon about it.

Bottom Line: The three main treatment options for anterolisthesis include rest, physical therapy, and surgery. In some cases, all three will be administered.

Anterolisthesis Risk Factors

Some people are more prone to develop this spinal condition than others. Here are some risk factors to consider:

  • Gender: Males are more likely to develop it than females. Why? Because they’re more likely to partake in high-impact physical activities.
  • Age: Like most diseases, the older you get, the higher your risk. That’s because as you get older, your body becomes more fragile and less adaptable.
  • Occupation: If you work in an occupation that requires a lot of physical exertion and hyperextension of the body, you’re more likely to get it.

Remember- these are only risk factors. They don’t guarantee that you’re going to get the condition.

You can reduce your risk by not engaging in potentially-dangerous high-impact sports. You can also reduce your risk by choosing a safer profession, as well as by not falling.

Bottom Line: The biggest risk factors for developing anterolisthesis include being male, being older than 65, and working at a physically-demanding job.

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