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The two main causes are from either a stress fracture in the vertebra called is when one vertebra slides off another vertebra in both the coronal (front to back) and axial planes (top to bottom).Due to the effects of gravity, certain severe cases of scoliosis can degenerate and become lateral listhesis.
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Degenerative or de novo scoliosis is the Adult Scoliosis that is a sideways distortion of the lower or lumbar spine combined with the arthritic changes that come with age. Patients usually present at our center with their scoliosis combined with loss of lordosis (normal curve of the low back seen from the side), AND often have a shifting of the vertebrae due to degeneration of their spinal joints.
Spondylolisthesis commonly occurs due to a fracture or defect in the pars interarticularis, the narrowest part of the posterior vertebral arch between the upper and lower facet joints.
When this is breached, the upper facet joint may no longer be able to hold the vertebra in place against the downward force of body weight and forward/downward slippage occurs.
Early treatment with a scoliosis specific exercise program and possibly adult scoliosis bracing is the best approach.
Surgery can be considered in more severe cases, but the benefits and risks to the patient must be carefully considered before that choice is made.Depending on the direction and location, this misalignment can be diagnosed as spondylolisthesis (forward slippage), lateral listhesis (side slippage) or retrolisthesis (backward slippage).), is an anterior (forward) slip of lumbar vertebrae (most often the fifth lumbar vertebra) and sometimes cervical vertebrae.About 5 to 7% of all people (with or without scoliosis) are affected by spondylolisthesis.is abnormal excessive movement (or “hypermobility”) between two vertebrae (bones of the spine).Between the vertebrae are intervertebral discs and stabilizing ligaments.The vertebrae are the bones that protect the spinal cord.Each vertebra has a thick drum-shaped area in front called a vertebral body.Patients need to be evaluated for the presence of instability, as if there is an unstable segment early surgery will be needed.If slippage is not more than 50% and there is no significant neurological compromise, treatment usually begins with non-operative measures but, if these fail, surgical intervention is generally indicated for pain relief and improvement of neurological symptoms.Although the underlying cause is not fully understood, degenerative scoliosis is associated with degenerative disk disease, failure of the small joints at the back of the spine, and a thickening of the major ligaments that are attempting to support the weakened spinal bones.This type of curvature with degeneration will often lead to nerve pain radiating down the legs and strong lower back pain and can eventually lead to a dangerous condition called postural collapse.