2. Spondylolisthesis surgery is usually the last resort for
management of the symptoms related to vertebral
slippage. Symptoms of spondylolisthesis might include
chronic pain, stiffness, tingling, reduction in range of
motion, numbness, or muscle weakness. About 90
percent of spondylolisthesis patients can find relief
through nonsurgical treatment methods such as pain
medication, strength-building exercises, stretching for
improved flexibility, and other methods. Surgery to repair
vertebral slippage is typically reserved for patients who
are experiencing severe physical limitations or have been
unable to manage their symptoms after several weeks or
months of conservative treatment.
3. Spondylolisthesis Surgery
is Highly Invasive
One reason so few spondylolisthesis patients may hesitate to have spondylolisthesis
surgery is the highly invasive nature of spinal fusion, which is the operation often
recommended to provide meaningful relief and long-term spinal stability. The surgery
– which can be used to reposition a slipped vertebra and permanently fuse it to a
properly aligned vertebra above or below it – requires overnight hospitalization, the
use of general anesthesia, a large incision, and the insertion of metal and plastic
stabilizing hardware. Bone graft material also is used in some cases to further
immobilize the affected vertebral segment.
The goal of spinal fusion is to reinforce the slipped vertebra in its
proper position and permanently immobilize the vertebral segment
That has been affected by spondylolisthesis. While this type of surgery
is successful more often than it is unsuccessful, there are many
risks and potential side effects that should be considered before
consenting to spinal fusion.
4. Potential Risk & Side Effects
In general, spinal fusion is followed by a long and arduous recovery process. Early on, recovery is focused on the healing
of the soft tissues affected by the surgery. Infection, if it occurs, typically develops within the first few days after
surgery.
There are several other potential drawbacks and side effects to be aware of when considering spinal fusion surgery.
These include:
• Fusion failure – A false joint, known as pseudoarthrosis, might develop if the bones don’t fuse as expected. If this
occurs, additional surgery might become necessary.
• Bone graft rejection – For a variety of reasons, including incompatibility, the body might not respond well to the
introduction of new bone material. The graft material is often taken from the patient’s own body to encourage
acceptance.
• Anesthesia allergy – A small percentage of patients experience adverse reactions to general anesthesia, including
a reduction of lung function while unconscious.
• Blood clots – Also known as thrombosis. Steps must be taken by the surgical team to avoid potentially life-
threatening problems, including pulmonary embolism.
• Infection – This is not all that common, but if it does happen it can be life-threatening.
• Nerve damage – A surgical instrument that cuts a nerve can cause permanent damage. This is exceedingly
rare, but can have devastating long-term effects, including paralysis.
• Range of motion loss – Anytime vertebrae are fused together, the patient can expect to permanently lose some
range of motion in that area of the spine.
5. Alternatives to Highly Invasive
Spondylolisthesis Surgery
Before deciding to undergo spondylolisthesis surgery or
spine surgery of any kind, there are a number of
conservative, non-surgical methods of treatment to
consider. These include
bracing, exercise, stretching, posture modification
therapy, chiropractic adjustments, and more. Many
patients require more than one of these types of
treatment, and they should work closely with their
doctors to formulate the right treatment plan. It’s
important to keep these treatment methods in mind if
you are unable to undergo surgical treatment for any
reason.
6. Minimally Invasive Surgery
Might Be an Option
Some patients with early-stage spondylolisthesis (25 percent
slippage or less) might find relief through minimally
invasive, outpatient procedures performed using
advanced, endoscopic techniques. These procedures generally
carry far less risk than spinal fusion, but are used to treat
nerve compression, rather than correct the actual vertebral
slippage.
No elective spine surgery should be consented to without first
seeking a second opinion to confirm the initial diagnosis and
to make sure no conservative treatment methods have been
overlooked.
