Anterolisthesis: Definition, Symptoms, Diagnosis

Anterolisthesis involves an alignment problem in the spine.  One of the spinal vertebra moves forward in relation to the others.  This can be diagnosed on imaging studies of the spine like X-ray, CT and MRI.  Anterolisthesis can cause  pain and pinched spinal nerves.  Treatment may be medical and in severe cases surgical.

What is anterolisthesis?

Anterolisthesis is when one vertebra moves forward in relation to the one below or above it.  We say there is Anterolisthesis of L4 on L5.  That means that the fourth lumbar vertebra has slipped forward in relation to the fifth lumbar vertebra.

Anterolisthesis grading

The severity of anterolisthesis is graded from 1 to 4.  Grade 1 slippage involves less than 25% of the vertebra.  Grade 2 involves 26-50% slippage of the vertebra.  Grade 3 involves 51-75% slippage of the vertebra.  Grade 4 involves greater than 76% of the vertebra.

Anterolisthesis vs spondylolisthesis

Anterolisthesis means that a vertebra in the spine has slipped forward.  Spondylolisthesis means that a vertebra has slipped in relation to the ones next to it.   Spondylolisthesis does not specify the direction of slippage.

What causes anterolisthesis?

There are many causes of anterolisthesis.

Blunt trauma or spine fractures can cause slippage of the vertebra.

Aging can cause movement of the vertebra.  This occurs as the cartilage between the vertebra thins.

Arthritis of the spine can cause the vertebra to shift.

Spinal tumors can also cause one vertebra to shift in relation to another.

Symptoms of anterolisthesis

The symptoms will depend on the degree of slippage and what part of the spine is involved.  There can be a pinched nerve.  Patients may have pain, spasms, weakness, tingling sensations, and difficulty walking.

How is anterolisthesis diagnosed?

Anterolisthesis is diagnosed on imaging studies of the spine like X-ray, CT and MRI.  We will see one vertebra that is positioned in front of another.  The severity of slippage of the vertebra will also be determined.

Studies like CT and MRI will also help with identifying a cause.  We can see fractures, tumors, arthritis, and other conditions of the spine which may contribute to anterolithesis.   X-rays often do not provide enough detail.

What does anterolisthesis look like on imaging?

Imaging will often show one of the vertebra of the spine to not be in alignment with the other vertebra.  Anterolisthesis will mean that one or multiple vertebra are slipped forward.

Anterolisthesis on CT scan

CT scan will allow us to look at the alignment of the spine and see any slipped vertebra.  Anterolisthesis will be seen as one vertebra slipped forward in relation to others.  CT will also allow us to see any fractures or other conditions which may be contributing to the anterolisthesis.

Anterolisthesis on X-ray

Xray will also show us the alignment of the spine, best on the lateral view X-ray.  This is an X-ray taken from the side of the patient.  We will see a shift of one of the vertebra in front of another.

Anterolisthesis on MRI

MRI will also show us anterolisthesis.  This will best be seen on the sagittal sequences.  These section the spine from side to side.  An advantage of MRI is that we will see great detail of all the surrounding structures which can be contributing to anterolisthesis.

Is anterolisthesis dangerous?

Usually not.  In severe case there can be difficulty walking and loss of bladder function.

Is anterolisthesis degenerative?

One of the most common causes of anterolisthesis is aging and degenerative arthritis.

What type of doctor treats anterolisthesis?

Non surgical treatment of anterolisthesis can involve primary or specialty care.  Surgical treatment will be by a spine surgeon.

Anterolisthesis treatment

Mild cases can be treated with pain medications, physical therapy, and excersises to strengthen supporting muscles.

Surgical therapy is reserved for more severe cases.  This involves removing bone to relieve pressure on bones and nerves (decompression surgery).  Fusion involves stabilizing the spine.  The procedures may be combined to treat anterolisthesis.

Anterolisthesis: summary

Anterolisthesis is an alignment problem of the spine.  One of the vertebra slips in front of the other.  This can cause pinched nerves and pain.  Anterolisthesis is diagnosed on imaging studies like X-ray, CT, and MRI.  The severity is graded on a scale of 1 to 4.  Treatment of mild cases may involve medications and physical therapy.  More severe cases may involve surgical therapy.