The Brain Charity

‘I can’t carry on like this’, these are the emotive words I said to a loved one once as I went to bed with my agonising spondylolisthesis. You see, going to bed and waking up with it are the times when I most despair.

Help is on the way, though, thank goodness, hopefully restoring me to something like the person I used to be.

What is spondylolisthesis?

In simple terms, spondylolisthesis means a slipping forward of one of the bones in your spine, called a vertebra. It can affect you anywhere in your back, but most cases involve the lumbar spine because this area bears most of the weight and movement.

The five grade variations of spondylolisthesis

In total, there are 5 grades of spondylolisthesis. I was diagnosed with grade 1 with pars defects, which means the smallest amount of movement. Great, I thought; I only have the mildest form of this condition. Such relief was, however, severely misplaced.

The five grade variations of spondylolisthesis are based on the Meyerding grading system, which classifies the condition by how far one vertebra has slipped forward over the one below it:

Grade I – 0–25% slippage
Lower; often asymptomatic or lower level symptoms.

Grade II – 26–50% slippage
Moderate; may cause back pain or mild nerve symptoms.

Grade III – 51–75% slippage
Severe; commonly associated with nerve compression and functional limitation.

Grade IV – 76–100% slippage
Very severe; significant instability and neurological symptoms are common.

Grade V (spondyloptosis) – >100% slippage
The vertebra has completely fallen off the one below; rare and usually requires surgical management.

What is a pars defect?

The bit I sort of did not grasp initially was the pars defects diagnosis, which means I have a stress fracture to the bony bridge that typically stabilises my vertebrae.

As a consequence, I have severe nerve compression that is giving me severe sciatica. I also have arthritis as well as a disc bulge in this area.

The symptoms of spondylolisthesis

As I have aged, my symptoms have got a lot worse. In my younger days, I used to be able to play cricket and go to the gym; however, now I am in intense pain merely walking around the house.

It hurts to stand up to brush my teeth, to stand as I shower, and also to bend as I get dressed.

What I want those not affected to know

If you have never had back pain before, then I want you to know just how exhausting it can feel. At times, it can feel all-consuming and strip you of your identity.

Treatment options for spondylolisthesis

Many sufferers of spondylolisthesis, especially those with grades 2-3 with no nerve compression, can find relief with painkillers, heat/ice, and physiotherapy. I, however, had to see a neurosurgeon who outlined my options.

· Gabapentin (can calm overactive nerves that are causing pain)

· Epidural steroid injection

· Spinal fusion surgery

Initially, I opted for an anti-inflammatory epidural injection. It will not cure my nerve compression or spondylolisthesis, but it should reduce the swelling around my nerve roots.

This will hopefully ease the stabbing pain in my left buttock down to my calf, so I can start enjoying life once again.

Long-term outlook for people with spondylolisthesis

The problem with injections for back pain, however, is that they typically only last for up to six months. I have now got my head around the fact that I will more than likely have to have major spinal fusion surgery in the near future.

If this enables me to start living the life I want to lead again, then I am all for it.

A message of hope

To my fellow spondylolisthesis sufferers out there, I say we are so much more than our pain. This is just a minor speed bump we have to navigate over in life. Together we are one, united not only in pain, but also united in the recovery road ahead.