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Anterolisthesis of L4 (the fourth lumbar vertebrae) is a mechanical injury where the L4 segment "slips" forward over the L5 segment below. Sometimes this happens as a result of a fracture of L4 at the pars interarticularis, which connects it to the rest of the vertebral column and stabilizes it against abnormal motion. Sometimes it happens without evidence of fracture on the Xray, and this type is due to instability, core weakness, and poor postural habits that eventually lead to mechanical breakdown or "degenerative changes" in the segment. This can occur with or without disc bulge, or herniation.

Ultimately, the pain cycle worsens due to muscular guarding or spasms, in which the body tries to protect itself. As muscles tighten and inflammation increases around the tissues in the spine, disc, nerve roots, and pain receptors generate even more pain, creating a vicious cycle. Pain may be felt down one or both legs, and weakness of the legs may sometimes be noted (leg muscle weakness is a serious warning sign and should be dealt with immediately!). Diagnosis is usually made by doctors putting together clinical signs and symptoms and an Xray (picture of bony tissue), but sometimes an MRI is needed to rule out more involved disc or soft tissue problems. Anti-inflammatories may be given by injection or by mouth to calm the body's pain response and decrease pressure on nerve roots or disc tissue.

If you think you have a possibility of anterolisthesis or instability in the lumbar spine and severe pain has not eased after 3 days, you MUST go to an MD (orthopedic or neurologist preferred) and he/she will most likely order a spine Xray to diagnose the problem (request one if they do not order it!). Most MD's will want to try a conservative approach first; do not let a doctor talk you into surgery without a second opinion and at least one trial of conservative therapy!!! Research shows that surgical interventions will fail more than 50% of the time, whereas conservative management costs less and is more effective in long-term healing and functional recovery!!

With a doctor's order (depending on state laws, you may be able to see a PT without MD order), a licensed physical therapist can evaluate the musculoskeletal dysfunctions and create a customized exercise and pain management program to help the patient get back to normal, pain-free function. The treatment (2-3 times/week for approximately 1-2 months--depending on the individual's response) may include ultrasound, electrical stimulation (to ease pain and improve circulation), heat, massage, manual therapy, ice, and gradual core stabilization and strengthening exercises to recondition the abdominal and back muscles. Other interventions might include postural training to align the spine, ergonomic changes at your desk to decrease work strain, functional training and injury prevention, back safety education on proper lifting and repetitive motion, support braces as needed, breathing/relaxation techniques to reduce muscle tension and decrease pain, and lifestyle modifications such as diet and exercise routine. The P.T. will reassess the patient intermittently to determine if the right amount of progress is being made, and will report this back to the Doctor Who ordered the therapy.

Do not allow the pain to go on for too long without addressing it!! It will only get worse and harder to heal. Pain is your body's way of telling you something is wrong--Don't ignore it!! It can get better with the right approach!!

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13y ago
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9y ago

Anterolisthesis of L3-L4 means that vertebrae 3 and 4 in the lumbar region of your spine is out of position. This is more commonly known as a slipped disk.

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11y ago

dont no

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Q: What is anterolisthesis of l4 and l5?
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