The most common complaint of patients with spondylolisthesis is low back pain. At first, there is a feeling of fatigue and awkwardness in the lower back. Then periodic pain appears in the lower back and sacrum, intensifying after physical activity. Sometimes the pain can spread to the groin area. This is due to overstretching of the facet joint capsule caused by the displacement of the vertebrae, which causes lower back pain. Pain only in the lower back is characteristic of spondylolisthesis of the 1st degree, less often of the 2nd degree. In more severe cases, with spondylolisthesis of grade II and above, compression (squeezing) of the spinal roots occurs, which causes numbness in the limbs, pain and or weakness in one leg or both legs. Pain in the legs or leg can also be a concern when there is a combination of minor spondylolisthesis and disc herniation when they are localized in the same spinal motion segment. In the case of spondylolisthesis of grade III or higher, the patient may have problems with pelvic functions in the form of delayed urination, constipation.
The diagnosis of spondylolisthesis is established based on questioning the patient about his complaints and the development of the disease (history), assessment of neurological symptoms (determination of areas of decreased sensitivity, decreased severity of tendon reflexes, decreased strength in individual muscles), X-ray and MRI data. The gold standard among methods for visualizing intervertebral disc herniation is Magnetic Resonance Imaging (MRI). It is this method that most adequately reflects the condition of the spinal cord and spine, and is also able to accurately diagnose the degree and cause of listhesis. It should be noted that the quality of the image of your spine on a tomogram depends on such an indicator of the device as the magnetic field strength. Currently, to obtain good MR images, this figure must be 1.5 Tesla. Devices with lower magnetic field strengths, as well as computed tomography (CT) data, provide an unclear picture and make it difficult for the neurosurgeon to choose a treatment method.
Sometimes, when describing MRI images of the lumbar spine, vertebral listhesis falls out of the radiologist’s field of view and in the description of the images, a herniated disc appears in the first place. If the neurosurgeon also does not pay attention to the presence of listhesis and only performs removal of the disc herniation, the patient will subsequently be bothered by chronic lower back pain, which intensifies with movement and various loads.
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To decide on the choice of treatment method, you must make an appointment with neurosurgeon Oleg Vladimirovich Durov by phone: +7 (499) 390-35-72.
Those wishing to undergo an internship in spinal neurosurgery under the guidance of Oleg Vladimirovich Durov for 6-24 months can call the administrator at +7 (499) 390-35-72. Preference is given to young doctors who have completed residency in neurosurgery with Russian citizenship.