Spondylolisthesis

Types of spondylolisthesis include:

1. Congenital spondylolisthesis

• Occurs when a baby’s spine doesn’t form the way it should before birth.
• The misaligned vertebrae put the person at risk for slippage later in life.

2. Isthmic spondylolisthesis

• Happens as a result of spondylolysis.
• the crack or fracture weakens the bone.

3. Degenerative spondylolisthesis,

• the most common type,
• Happens due to aging.
• Over time, the disks that cushion the vertebrae lose water. As the disks thin, they are more likely to slip out of place

Less common types of spondylolisthesis include:

1. Traumatic spondylolisthesis

• happens when an injury causes vertebrae to slip.

2. Pathological spondylolisthesis

• Occurs when a disease — such as osteoporosis— or tumor causes the condition.

3. Post-surgical spondylolisthesis

• It is slippage as a result of spinal surgery.

Grades of spondylolisthesis

• Low-grade (grade i and grade ii)
• typically don’t require surgery.

• 
  Low grade cases are usually seen in adolescents with isthmic spondylolisthesis and in almost all cases of degenerative spondylolisthesis.

High-grade (grade iii and grade iv) 

• may require surgery if you’re in a lot of pain.

• Muscle spasms in the hamstring(muscles in the back of the thighs).
• Back stiffness.
• Difficulty walking or standing for long periods.
• Pain when bending over.
• Numbness, weakness or tingling in the foot.

Physical therapy:

• A physical therapist can teach you targeted exercises to strengthen your abdomen (belly) and back.
• Daily exercises often relieve pain after a few weeks.
• The rehabilitation exercise program should be designed to improve muscle balance rather than muscle strength alone. 
• Good exercise choices include:

Isometric and isotonic exercises beneficial for strengthening of the main muscles of the trunk, which stabilize the spine. These techniques may also play a role in pain reduction

• Core stability exercises

Useful in reducing pain and disability in chronic low back pain in patient with spondylolisthesis.

 antilordotic movement patterns of the spine

 elastic band exercises in the lying position.

• Gait training
• Stretching and strengthening exercises,

Objective of stretching and strengthening is to decrease the extension forces on the lumbar spine,

Stretching exercises of the hamstrings, hip flexors and lumbar paraspinal muscles are important.

• Balance training including –

Sensomotoric training on unstable devices

Walking in all variations,

• coordinative skills

Hydrotherapy

Endurance training of muscles

Effective for chronic low back pain.

• Cardiovascular exercise –

Athletes with spondylolysis and first-degree spondylolisthesis can take part in all sports activities.

• However, attention should be given to those kinds of sport where recurring trauma resulting from repeated flexion, hyperextension and twisting is usually undertaken (e.g. Gymnastics, aerobics, swimming in the dolphin technique).
• LWilliams flexion exercises

 are a set of exercises that decrease lumbar extension and focuses on lumbar flexion. These include

• Pelvic tilts
• Partial sit-ups
• Knee-to-chest
• Hamstring stretch
• Standing lunges
• Seated trunk flexion
• Full squat

Spondylolisthesis is a spinal condition in which one vertebra in the spinal column slips forward over the vertebra below it. This can occur anywhere along the spine, but it most commonly occurs in the lower back (lumbar spine). Spondylolisthesis is classified into different grades based on the degree of slippage, with grade I indicating a mild slip and grade V indicating a complete slip.