Non-surgical management of lumbar spondylolisthesis will typically involve over the counter anti-inflammatory and analgesic medications such as NSAIDs, as well as physical therapy. Improving core strength has excellent effects on back pain, and lifestyle modifications may improve quality of life significantly. Steroid injections may also be performed to provide long term relief, however, are not recommended in patients for whom relief does not last for several months.
In patients unable to achieve satisfactory results with non-surgical options, decompression surgery with or without fusion will typically be performed. Decompression involves removing part of the bone and disc to improve the space within the spinal canal, and fusion may be necessary to then stabilize the vertebral column. Bone grafts are typically used to facilitate the fusion of vertebrae. These grafts may come from the patient themself, a cadaver donor, or a synthetic source depending on patient preference. Most patients will be up and walking the day after surgery, but three to six months are recommended before returning to all normal activities.
In less severe cases, physical examination and patient history are usually enough to make a tentative diagnosis. In more severe cases, however, imaging will often be necessary to evaluate the structures of the back, especially if considering surgery as an option. X-rays can provide rapid and clear visualization, but MRI and CT are sometimes ordered for a more detailed look into the nature of the condition for a given patient.
DAY OF SURGERY INFORMATION
Drive to the South parking garage. Free Valet parking is available during business hours. If you self-park, take the elevator from the garage to the first floor to enter the main hospital lobby. Wheelchairs are available if needed. Take the D elevator to the 2nd floor. Proceed to the Surgical and Endoscopy Check-In Desk. Here you and your family will be checked in and escorted to the Pre-op Area to be prepared for surgery. Up to two family members may wait with you until you are taken to surgery. Your family may then wait in the Surgical Waiting room until notified by the surgeon that the surgery has been completed. A receptionist will take down contact information so that your family may be easily reached to speak with Dr. Paul. Complimentary coffee is available for your family while in the Surgical Waiting room. The cafeteria and gift shop are on the ground floor in the North area of the hospital and the coffee shop is in the South area of the hospital for your family’s convenience.
In the preoperative room you will be prepared for surgery. The team will be checking your vital signs, starting your IV, validating your medications, health history, lab results and any follow up for additional testing needed. At this time, they will obtain your consent for surgery and answer any questions you may still have. Your anesthesiologist will see you and your family prior to your surgery. Dr. Paul, Adam or Kevin will mark your surgical site. You will be escorted to the operating room by cart. Your family can wait in the surgical waiting room. Dr. Paul will call them when surgery is completed. If he can not reach them, he will leave a message with the Patient Liaison. Following surgery you will be taken to the Post Anesthesia Care Unit (PACU) where you will recover for an hour or more. During this time, pain and nausea control will be established and your vital signs will be monitored frequently.