Spinal instability is a term which is used to describe abnormal movement, greater than normal range of motion, between one vertebra and another. This condition commonly occurs when a particular disc or facet joint degenerates to the extent that it can no longer support the body weight through that segment of the spine. This abnormal slipping or overriding of the face joints causes arthritis overgrowth of the joints as well as the products of bone spurs around the joint margins.

Causes

The slippage mentioned above is called spondylolisthesis which means the forward slippage of one lumber vertebra in relation to the vertebra below. It may be caused by different mechanisms. The two major causes are from either a stress fracture in the vertebra (spondylolysis) or by acquired degenerative changes in the facet joints.

Spondylolysis- A stress fracture occurs due to a fragile part of the vertebral bone namely the “pars” and is commonly broken on both sides. The fracture may be the outcome of a direct trauma, from a genetic weakness in this area of the bone, or through a focused strain mostly from athletic activity. This is a thin bone that may break with the repeated use; think of a paperclip that has been bent over and over and finally breaks.

Facet Joint- Other common cause of spondylolisthesis is acquired degeneration of the facet joints. With the degeneration of these joints, the small supporting ligaments wear out and become loose. These ligaments are important for support. The facet joint can cause pain and allow the disc to slip forward since the joint is separating more than it needs.

Symptoms

Spinal instability presents itself as significant back pain or spasm usually caused by nerve irritation as an outcome of the irregular micro-movements. Moreover, this pain may occur along with a catch or locking feeling of sudden sharp pain. In most cases, it happens when one is mid-way through standing upright from a seated position.

Treatment

We at Vimhans PrimaMed Institute of Minimal Invasive Surgery primarily recommend soft tissue release, core strengthening, and exercise. If these procedures don’t respond to pain, we opt for pain management techniques, such as injection and/or pain medication. When all non-operative modalities fail to eliminate the pain, surgery may be the option.

Depending upon the severity of pain and condition of the patient, spinal fusion is usually the preferred procedures. We at Vimhans PrimaMed perform spinal fusion with modern techniques in a minimal invasive approach for yielding highly successful results. Minimal invasive procedures ensure quicker recovery, less blood loss, and minimum hospital stay and allow patients return to a full and active lifestyle.

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