Difference Between Spondylolisthesis, Spondylitis and Spondylosis By Shubham Gautam

By Shubham Gautam, Treasurer , National Student's Wing

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These three conditions affect the spine and may be confusing. What is the difference between, spondylolisthesis, spondylitis, and spondylosis?

ℹ️Spondylosis

Spondylosis can affect any region of the spine. It is most common in the neck and lower back.

It involves a defect in the pars interarticularis–a piece of bone attaching the facet joints at the back of the spine.

This condition is a form of spinal degeneration occurring due to the natural effects of aging. As we grow older, normal wear and tear, as well as cellular changes, affect the structure of the spine. As a result, the soft tissues supporting the spine–discs, muscles, tendons, etc.–slowly begin to deteriorate.

For example, the discs protecting the spine tend to dry out and lose shape as we age. This condition, known as degenerative disc disease, puts pressure on the discs and may cause a bulging or herniated disc.

When the soft gel-like layer of the inner disc breaks through the thick fibrous tissue of the outer disc, it often affects spinal joints and can compress nerves. In addition, cartilage can wear away from the joints leading to facet joint osteoarthritis.

Spondylosis, however, doesn’t only affect older people. In fact, adolescents may develop the condition.

Those participating in sports requiring repeated hyperextension of the lower back are at risk.

♻️This includes gymnastics, rowing, wrestling, and track & field sports. Younger people may not have many symptoms, so the condition may not get diagnosed. It spondylosis isn’t identified and managed correctly, however, it can result in more serious problems.

ℹ️Spondylolisthesis

When spondylosis is left untreated, it may lead to spondylolisthesis. Spondylosis involves the separation of the pars interarticularis. In contrast, spondylolisthesis is defined by a slipped vertebra. When one bone of the spine slips forward over another, it causes damage to the spinal structure.

In some cases, a stress fracture may be to blame. Other times, damage to the intervertebral discs may cause this instability of the spine.

Family history and even congenital defects can contribute to this condition. It is often the result of certain sports and physical occupations. The lower back is responsible for carrying a lot of the body’s weight.

♻️Some activities make the spine more prone to developing spondylolisthesis. For example, gymnasts, football players, and weightlifters of all ages can develop this condition.

Those that work in warehouses or delivering packages are also susceptible since they may bear a lot of weight on one side of the body and do a lot of bending. In addition, age-related degeneration of the spinal structures plays a role.

♻️Types of Spondylolisthesis:

ℹ️Congenital

ℹ️Isthmic – Most common: usually occurs due to pars defect (L5 – common)

ℹ️Degenerative – Occurs as a result of facet arthritis; Females older than 50 yrs.; African Americans; Usually affects the L4-L5 level;

Typically the slip is not bad and rarely exceeds 30%; Commonly associated with instability and lumbar stenosis. May need flexion extension X-ray views to check for instability.

Other Rare Types:

➡️Traumatic

➡️Pathologic

➡️Post-Surgical

⚠️Grades of Spondylolisthesis:

Type I (less than 35%)

Type II (25-50%)

Type III (50-75%)

Type IV (75-100%)

Type V (spondyloptosis)

ℹ️Spondylitis

Spinal conditions can also be due to arthritis. This condition, sometimes known as spondyloarthropathy, is a type of inflammatory rheumatic arthritis. Unlike other forms of arthritis, it affects areas where the ligaments and tendons attach to the bones.

♻️Though the exact cause is unknown, many people with the gene HLA B27 tend to develop the condition. In addition, some research suggests an infection can trigger this condition. 

Spondylitis usually occurs in young adults between 17 and 35 years old.

Symptoms include chronic pain and lower back stiffness that gets worse after resting for a long time

By Shubham Gautam
Treasurer , National
Student’s Wing

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