A spondylolisthesis is a shift of two or more vertebrae towards each other. This shift is a sign of instability, often due to a disc wear. The spondylolisthesis can be associated with nervous pain in the legs and back pain in terms of a capsule stretching pain but also muscular imbalances. It is often initially treated conservatively with physical therapy to stabilise the spine or a corset as an outer support. This may temporarily relieve the symptoms. However, the pain relief is often not for the long run, so that eventually the question of an operation comes up. The goal of an operation in spondylolisthesis is to restore the balance and stability of the spine and the removal of bottlenecks, where nerves are compressed, as oftentimes a spondylolisthesis goes along with a narrowing of the spinal canal (spinal stenosis) or the nerve exit points (foraminal stenosis).
The operation is generally from the rear (back), where first the narrowing of the spinal canal will be removed. Then the disc is removed and the vertebral bodies are brought back into position. Then placeholders are inserted into the disc tray, which have the task of restoring the original spacing between the vertebral bodies. In addition, bone or bone substitute material is inserted. This is supposed to precipitate the acampsia. Since this structure is not yet stable, an additional screw-rod system is implanted in the affected vertebral body, which stabilises the segment until the bony fusion commences. As a result, the original shape of the spine will be restored. The surgery can be done in a minimally invasive, microsurgery way, so that the postoperative recovery period is short and the patient can leave the hospital after about one week. There follows a physiotherapy rehabilitation of 3-6 week, to relax the muscles first and then to activate them. After 6 weeks, the strength is largely restored.
Frequently Asked Questions
How long is the stay in the hospital after an operation?
The average length of stay in the hospital is one week.
What happens after discharge from the hospital?
After discharge from the hospital, further support in my practice will be carried out. In the first three weeks primarily resting and relaxation applies. The muscles are still swollen and under-bleed. I first prescribe de-swelling measures such as drainage and gentle massage. In addition, the patients will be treated with pain therapy, mainly with 3 x 600-800mg ibuprofen.
From the 4th Week physiotherapy exercises with activation of the back muscles begin. This is to eliminate poor posture and deformity and the restoration of the spinal balance.
After about 6-8 weeks, the resilience is restored.
Must one go to a rehab after an operation?
Rehabilitative measures are appropriate. Intensive physiotherapy exercises, and other applications can strengthen the back muscles and quickly improve the movement, the gait and motor function. Rehabilitation should only take place after 6-8 weeks if the consequences of the operation are resolved. For an early rehabilitation the resilience is limited and various applications cannot be performed. If, however, significant limitations in the independence and mobility have existed before the operation, a so-called following treatment shortly after the stay in hospital, to improve the activity levels, can be initiated. However, some limitations in the implementation of applications have to be accepted and appropriate load limits should be recognized.
Can you still move after such an operation?
The stiffness in a spinal segment has no major impact on the mobility. Often this is even improved compared to the state before the operation, as from muscle tension and pain, reflex movement restrictions result.