The treatment options depend on the extent of spondylolisthesis and the symptoms it causes. Conservative treatment is prescribed for patients who have very mild spondylolisthesis and intermittent back pain. Non-surgical treatment involves pain killers, weight loss and physiotherapy or hydrotherapy. These are the best forms of supportive treatment.
Surgical treatment may be a consideration when:
- Patients do not respond to conservative treatment
- The patient’s symptoms are progressively worsening
- Patients have symptoms of neural compression including numbness, weakness or difficulty walking
The goal of surgical treatment is to decompress the spinal canal and spinal nerves. It also aims to bring stability to the spine. Stabilisation is achieved by inserting pedicle screws or rods and performing interbody fusion. The interbody fusion component of this operation uses multiple techniques.
Depending on anatomical constraints, the options of spinal fusion are:
- Posterior lumbar interbody fusion (PLIF)
- Transforaminal lumbar interbody fusion (TLIF)
- Lateral lumbar interbody fusion (LLIF)
- Anterior lumbar interbody fusion (ALIF)
The team at Neuroaxis have experience performing all the above spinal fusion options. The choice of surgery is usually guided by a combination of factors. This includes a careful analysis of the patient’s scans and understanding the anatomical limitations if any.
The vast majority of these fusions are performed using keyhole surgery techniques. The spinal fixation part of the operation is commonly performed using robotic spine surgery or using navigation techniques.
In the case of an anterior lumbar interbody fusion, an experienced vascular surgeon will assist the operation.