High and Low Grade isthmic
As stated earlier, Spondylolisthesis is the forward or backward slippage of the vertebra in the vertebral column. When the condition occurs due to some fracture in inter-vertebral pars then such type of spondylolisthesis is regarded as the “Isthmic Spondylolisthesis”. Commonly it is seen that the slippage in Isthmic condition occurs between the L4-L5 and L3-L4 of the lumbar spine, however the last of the lumbar spine L5 is more likely to slip over the first one of sacrum S1.
In terms of Isthmic, there are two further divisions, which are High-Grade Isthmic and Low-Grade Isthmic. Low-Grade Isthmic is referred when less than 50% of the vertebra is moved forward. Whereas, the condition in which more than 50% vertebra is shifted forward, is known as High-Grade Isthmic.
The treatment of Isthmic Spondylolisthesis is also dependent on the condition whether it is low-grade or high grade. Low-grade usually require conservative treatments, which means that surgical treatments are not approached. Pain-killers, physiotherapy and other medicines are prescribed to the patient since it is mostly expected that the low-grade condition remains as it is and does not tend to get worse, therefore can be treated by medicines and rubbing massages. There are very less chances for low-grade isthmic to proceed towards a high-grade one. When such condition is found, then the way of treatment is different.
For this case, surgery may be performed to bring the vertebra back to its original position. In high-grade isthmic, more than 50% of the vertebra is shifted forward or backward from its actual position. This condition is a bad one as it causes a lot of pain and stress to the patient.
This may need a surgery or bracing of the spine. By this method we can bring the vertebra back to their original position but on the other hand this approach may also be risky and tend to cause a big loss of the life of patient.