Causes and Types
There are five general causes for spondylolisthesis. Isthmic spondylolisthesis results from a stress fracture in the back part of the spine (a cracked vertebra, or spondylolysis), and most commonly develops between ages 5 and 8. It may or may not cause back pain. Five percent of the adult American population has it. Fifty percent of Eskimos and 10% of professional football linemen playing in the NFL have it. It is also a common source of back pain in highly competitive gymnasts, occurring in up to a third of these athletes.
The most common type of spondylolisthesis is caused by degenerative changes in the spine, particularly in the facet joints. As these joints wear out, they become lax and fail to maintain normal spinal alignment. The same arthritic process that wears out the joints in the spine can also cause bone spurs to grow which then cause nerve compression and spinal stenosis. Stenosis and degenerative spondylolisthesis occur together very often.
Rare causes of spondylolisthesis include tumors or infection that destroy the back part of the spine, and acute fractures through the back of the spine. These destructive processes disrupt spinal stability and allow the affected vertebra to slide forward on the one below it. Somewhat rare is the congenital type of spondylolisthesis that features malformed joints in the back of the spine which allow the spine to slip.
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