Spondylosis vs Spondylolysis vs Spondylolisthesis: What’s the Difference?

Spondylosis vs Spondylolysis vs Spondylolisthesis - PMIRSpondylosis vs spondylolysis vs spondylolisthesis. What do all these conditions have in common? The answer is the spine. Spondyl or spondyle is another word for vertebra and traces its origin to the Latin and Greek spondylus/spondylos, which gave us the medical prefix ­­spondylo-, as in spondylosis and spondylolisthesis.

Similarly, the back half of each word indicates what it is about. Spondylosis describes a problem with vertebrae and is usually used to describe general arthritic wear and tear in the spine.

Spondylolysis describes a defect in which a tiny portion of bone is separated from the rest of the joint. It is also known as a pars interarticularis defect.

Spondylolisthesis refers to instability between two vertebrae, causing a joint to slip out of alignment with the rest of the spine, from the Greek oliothesis, or “slipping.”

Spondylitis, another similarly named condition, is an inflammation of the bone and surrounding area. One particularly dangerous form of spinal inflammation is ankylosing spondylitis. This condition can result in the fusion of one or more spinal joints, making the spine much more likely to fracture and causing extreme pain.

Our vertebra comprises a column of stacked bones, each separated by specialized discs that allow it to retain flexibility while benefiting from the rigidity and protection afforded by bone. But like other parts of the body, the spine has its limitations and can suffer from different illnesses and injuries. Continue reading for an in-depth analysis of spondylosis vs spondylolysis vs spondylolisthesis.

What is Spondylosis?

Spondylosis is a general term for the wear-and-tear of the spine’s joints due to aging or an arthritic condition. Spondylosis is estimated to occur in about 90 percent of people over 60, and it is generally asymptomatic, meaning most people with some form of degeneration in the spine will not necessarily feel pain or any other adverse effects as a result.

When spondylosis does cause pain, it is usually because the level of support afforded by a weakened spine is drastically reduced. Degeneration in the vertebrae can lead to other issues in the back, including nerve compression (such as sciatica), pain in the limbs, and numbness or random prickling sensations.

Treatment of Spondylosis

Other, more severe spinal conditions related to spinal and disc degeneration include spinal stenosis (a narrowing of the spinal cord cavity) and nerve damage. If you are diagnosed with spondylosis during a routine visit to the doctor, do not worry. Spinal degeneration is normal, and taking the appropriate steps to minimize the impact of wear and tear on the spine through regular physical activity and healthy lifestyle choices can reduce or eliminate the risk of symptoms or progressive spinal health issues.

But if you are experiencing severe pain, numbness, loss of feeling, strength, or other abnormal symptoms in your arms, legs, chest, or neck, you may want to consult a doctor immediately.

What is Spondylolysis?

Spondylolysis is a rarer condition in which the bony arch on the back of your spinal joints is separated from the rest of the bone. It is commonly diagnosed in young athletes, especially those that experience continuous and heavy axial loading (i.e., spinal compression), especially in the lower back, as a result of their sport. Usually, physical trauma or chronic physical fatigue may cause spondylolysis, also known as the pars interarticularis defect.

Treatment of Spondylolysis

While the cause is excessive mechanical stress, excessive is the keyword here. Treatment usually involves physical therapy, core strengthening exercises, and further diagnostic work to rule out other related spinal conditions (such as SI joint pain, lower back muscle strain, or spondylolisthesis).

If physical therapy fails to improve symptoms, a patient may be given a special back brace to promote healing and support the lower back.

What is Spondylolisthesis?

Spondylolisthesis is the most severe of the three conditions and refers to a slipped or slipping spine joint.

Your spine is ideally in alignment for most of your life, although there are individual variations – most people’s spines aren’t entirely straight, and degrees of imbalance is to be expected. But in cases of severe spinal deformation, injury, or a related illness (such as disc degeneration and arthritis), your vertebrae may shift relative to the rest of your spinal column.

This is called spondylolisthesis. It is most common in older people but can occur due to injury or a pre-existing spinal health problem in younger patients. Spondylolisthesis usually occurs when the facet joints – which keep your vertebrae locked together – degenerate or break. The spinal joint in question does not have to shift significantly to be concerning – a shift of a few millimeters can often be enough to cause pain symptoms, as the surrounding nerve roots are affected by impingement or pressure from the bone.

Treatment of Spondylolisthesis

Pain medication used to treat pain symptoms due to spondylolisthesis may include over-the-counter pain relievers and more intense options, such as epidural injections. If the shift is minor, a doctor may prescribe some simple activity modification to manage and reduce pain until your back heals. This may include less activity if you are active or work a manual labor job or some slight activity if you are primarily sedentary.

While a shifting spine can be dangerous, surgery is rarely needed. In cases where a doctor considers surgery your best option, most surgical treatments involve attempting to stabilize or fuse the affected joints with special hardware. Spinal fusion surgeries today are less invasive than in years past, requiring only a few minor incisions to create room for a small frame and attach the screws. Medication management is a common treatment option for pain associated with spondylolisthesis, including anti-inflammatory medications, muscle relaxants, and pain medication. Other treatment options could include celiac plexus blocks, facet block injections, hypogastric plexus blocks, and intercostal nerve blocks.

Should I Be Worried About My Back?

The spine is the bridge between the brain and the rest of our body, relaying information through a complex network of nerves. In keeping with its relative importance, the spine is also quite durable. Under certain conditions, our spine can withstand the physical stress of many times our body weight.

Yet it has its limitations, be they internal (such as decreasing bone density, spinal diseases such as spondylosis vs spondylolysis vs spondylolisthesis, or cancer) or external (such as whiplash forces, shearing pressure, and a concentrated blow on one area). While it’s one thing to hurt your arm or break your leg, an injury in the spine can have catastrophic consequences. As such, symptoms of a spinal condition can range from pressure and pain to life-altering and permanent paralysis.

If you have back pain, like millions of other Americans, it’s essential to distinguish between everyday complaints and a genuine cause for worry and concern. Many spinal conditions come and go – people go through their lives without realizing they may have a swollen disc or a minor spinal deformation. Sometimes, even acute back injuries heal independently through rest and physical activity.

But at other times, doing nothing can lead to worse outcomes or a completely different (and often worse) ailment. These can be time-sensitive physical health issues, and it pays to know when a doctor’s visit is warranted.

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