The spinal column of the skeletal system is responsible for the protection of our spinal cord and to take on most of our body weight. It has a unique s shape. The shape enables it to evenly distribute our weight and stress we put on our body. It starts from the back of our neck and stretches to the pelvis. A pain in the neck, upper back or lower back may be a sign of various spine-related problems. One of which is Grade 1 Anterolisthesis.
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What Is Anterolisthesis?
The spinal column is made up of 24 small bones called vertebrae stacked over one another, 4 bones making up the coccyx, and 5 bones forming the sacrum. They allow mobility and flexibility of the spine. There are flat discs separating the bones from each other. They are meant to the shock absorbers for the spine.
The upper vertebral body is drum shaped. When this upper vertebral body slips over the lower vertebral body, it is called ANTEROLISTHESIS. It is a form of spondylolisthesis. It is basically graded on the scale of 1 to 4 where 1 means minor(less than 25%) and 4 being extreme (more than 75%). The gradation is done on the basis of damage, pain and the area damaged. It also causes pinched nerves causing inflammation in the vertebrae. It generally happens in the 4th and 5th vertebral bone.
Grade 1 Anterolisthesis
When the slippage of the upper vertebral bone over the lower vertebral bone is less than 25%, it is graded under the grade 1 Anterolisthesis. When you visit a doctor and complain about pain in the back or spine, he may ask you get an x-ray done. A lateral radiograph through x-ray will identify the damage. The damage is generally divided into 5 grades.
Other Grades of Anterolisthesis
- Grade II: Slippage more than 25% and below 50% comes under this grade
- Grade III: Ranging between 50% to 75%
- Grade IV: Ranges between 76% to 100%. It is very severe.
- Grade V: When the upper two connected vertebrae are completely detached from one another, it falls under this grade.
Symptoms of Anterolisthesis
In the case of following symptoms of pain and inflammation in the neck, the upper back and the lower back, one should go to the doctor to determine whether the pain is just muscular or comes under Anterolisthesis. grade 1 Anterolisthesis is mild and thus the symptoms are also minor.
The most common symptom of Anterolisthesis is a pain. There is usually acute pain near the vertebral slippage. It may be local or spreading in a wide area. Some people also complain pain in the legs which is perceived weakness in one or both legs. It may become worse over time due to muscle spasms caused by the aggravation of the tissues near the spine, vertebral discs, or nerve roots.
- Other Symptoms
- Severe nerve compressions may cause failure in control of the bladder or movements of the bowel.
- There may also be tingling sensations and numbness in the legs.
- There may be a lack of mobility and agility in the lower back.
How to Treat Anterolisthesis
The treatment usually depends on upon various factors apart from the severity of the slippage. They may be age, general health conditions, and symptoms. Treating Grade 1 Anterolisthesis is quite moderate. Some medications, proper rest and precautions, and exercise may cure grade 1. But in severe cases, surgery is required.
- Moderate Treatment
- an x-ray determines the status of the slippage. Hence, it is required at regular intervals during the treatment process.
- Any physical exertion should be avoided. Thus sports or physical work should be suspended.
- A back support or brace can be utilised to reduce the pain and stabilise the back. Belts that support the back are quite useful during the treatment to reduce or stabilise the pain.
- Some over the counter drugs like ibuprofen and naproxen helps in reducing the inflammation. If it is not enough, the doctor may prescribe some steroid injections.
- Physical Therapy
the patient is required to do some physical exercises under the supervision of a specialised physiotherapist. The help in restoring the strength in the muscle and improves its flexibility. They also readjust the vertebrae.
Please watch out for this video to see some sample exercises
In some circumstances, when the above treatments fail to relieve the patient of the pain and doesn’t improve their condition, a surgery may be required, as the pain usually interferes with the daily activities of the patient
The surgery is done to restore the slipped vertebrae in its position, thus reducing the nerve and muscle tension. After a few days of the surgery, the pain slowly subsides. There are two types of surgery process:
- Decompressive laminectomy: This process has a major side effect. It may lead to an unstable spine, as in this process the part of the bone that is pinching the nerve and causing pain, is removed.
- Spinal fusion:It is a major surgery which generally lasts for hours. In this process, a bone is used to make a bridge between the slipped vertebrae. They help to keep the vertebrae in place thus blocking any slippage. They also help the damaged bone to heal and grow. In some cases, metal implants may be used instead of a bone, which holds the connected vertebrae together until the new bone is grown in its place.