badbackParticipantSeptember 18, 2018 at 7:03 pmPost count: 1
How bad is the 11mm of anterolisthesis? (An xray was taken shortly before this MRI, and the xray report categorized this as Grade 1 to Grade 2.)
I spoke with an orthopedic surgeon, and he recommended PT.
I also spoke with a neurosurgeon, and he recommended ALIF & PLIF, as he felt the slippage was too great to address from just the posterior (e.g. TLIF).
Vertebrae: Vertebral body heights within normal limits. There is 11 mm of anterolisthesis of L4 on L5 in the setting of pars defects. At L4/L5 there is near complete disc loss with endplate irregularity and edema of the L4 and L5 vertebral bodies, all of which demonstrates postcontrast enhancement. No definite associated epidural abscess is seen.
L4-5: There is 11 mm of anterolisthesis of L4 on L5 in the setting of pars defects. This results in severe bilateral neural foraminal stenosis.
L5-S1: Mild disc osteophyte complex No significant spinal canal stenosis. Moderate to severe left and moderate right neural foraminal stenosis.Donald Corenman, MD, DCModeratorSeptember 20, 2018 at 8:45 amPost count: 6700
11mm of slip (anterolisthesis or spondylolisthesis-same meaning) is significant when associated with pars defects. The disc is highly degenerative (“At L4/L5 there is near complete disc loss with endplate irregularity and edema of the L4 and L5 vertebral bodies”) which can actually be in your favor. If this slip is stable (there is little to no motion on flexion/extension X-rays) due to the highly degenerative disc which causes bone-on-bone contact and lots of friction and you have little in the way of symptoms, you could live with this.
Whether you can or cannot live with this condition depends upon your current symptoms and activity level. If you are comfortable with your day-to-day activities, have no motor weakness and are not impaired, you should be OK.
I would disagree with the neurosurgeon you consulted with regrind the type of surgery you would need if you had impairing symptoms. You do not need an ALIF and PLF but just a TILF.
Dr. CorenmanPLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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