The terminology used when describing spinal conditions is hard to pronounce and it’s made even more confusing by how similarly some of the conditions are spelled. There’s spondylitis vs. spondylolisthesis vs. spondylosis—all different conditions, all of them with the ability to affect your spine.
The prefix “spondy” simply means that the condition is occurring in the spinal column—that’s why all of the words look so similar. So, let’s break down each condition so you’ll know the difference between them and be able to describe your spinal condition to doctors and other members of your medical team.
Spondylosis
Spondylosis is a catch-all term for the wear and tear that affects the spine over time. Spondylosis is extremely common after a certain age—more than 85% of people older than 60 are affected.
While spondylosis can affect any part of the spine, it most commonly affects the cervical spine (the neck) and the lumbar spine (the lower back). The thoracic spine (the mid back) is often unaffected by spondylosis, as the ribcage stabilizes the spine and reduces wear and tear.
Most people affected by spondylosis experience no symptoms—the wear and tear does not necessarily result in back pain or limited motion. As a condition, spondylosis typically precedes other conditions, such as degenerative disc disease and spondylolisthesis.
Diagnosing and Treating Spondylosis
Diagnosing spondylosis depends, in part, on the area of your back affected by the condition. Your doctor may:
- Check the range of motion in your neck
- Check the range of motion in your lower back
- Conduct imaging tests like X-rays, MRIs, and CT scans
- Test reflexes, muscle strength, and sensory functions
- Palpate (press on) areas in the back that may be affected
Spondylosis is a broad term encompassing almost all wear and tear in the back. As such, your doctor will look for signs of that wear and tear, including:
- Narrowing of the spinal canal (spinal stenosis)
- Bone spurs
- Dehydrated discs
- Herniated discs
- Inflammation in the facet joints
- Degeneration of cartilage
Treatment for spondylosis will depend largely on the symptoms a patient is experiencing. Physical therapy, a back brace, and pain medications may be sufficient for low-grade cases. When spondylosis leads to other conditions, like spinal stenosis or degenerative disc disease, more aggressive treatments may be required, up to and including surgery.
Spondylolisthesis
Spondylolisthesis occurs when one of your vertebra slips out of place and falls onto the vertebra below it. Spondylosis can result in spondylolisthesis, but as you’ve now learned, the two terms are quite distinct.
At this point, it’s worth introducing another term: Spondylolysis. Spondylolysis is a stress fracture in the pars interarticularis—a bone segment which joins two vertebrae. This type of stress fracture is quite common in young athletes, especially in the lower back.
Spondylolysis and spondylolisthesis, aside from sounding similar, both tend to cause low back pain (though they can occur in other parts of the spine). They are, however, quite distinct.
Spondylolisthesis occurs as a result of a slipped vertebra which puts pressure on the vertebra below it. Typically, spondylolisthesis affects a lumbar vertebra. Most cases of spondylolisthesis do not cause any symptoms at all. When spondylolisthesis does cause symptoms, symptoms may include:
- Muscle spasms, especially in the hamstrings
- Stiffness in the back
- Difficulty walking or standing for long periods
- Tingling or weakness in one or both legs
- Pain with repetitive bending
Doctors typically describe two different types of spondylolisthesis—low-grade and high-grade. Low-grade spondylolisthesis may occur with almost no pain at all, and non-surgical interventions are usually sufficient.
High-grade spondylolisthesis, on the other hand, can cause severe pain and lead to other problems—in these cases, surgery may be the best option.
There are several different types of spondylolisthesis, including:
- Congenital spondylolisthesis, which is present at birth
- Isthmic spondylolisthesis, which occurs as a result of spondylolysis—this is why spondylolysis and spondylolisthesis are often linked.
- Degenerative spondylolisthesis, which can occur as a result of spondylosis
Diagnosing and Treating Spondylolisthesis
Doctors use many different methods to diagnose spondylolisthesis, including:
- Range of motion tests and other physical exams
- Neurological evaluations, including testing reflexes and a sensory exam
- Imaging tests, such as X-rays, CT scans, MRI scans and EMG (Electromyography)
For low-grade spondylolisthesis, doctors will often recommend non-surgical interventions to relieve pain and improve symptoms. These may include:
- Taking breaks from strenuous physical activity
- NSAIDs like ibuprofen or naproxen
- Other medications
- Physical therapy
- A back brace
For high-grade spondylolisthesis, a range of surgical interventions are available. Spinal fusion surgery may be an option, though spinal decompression may be sufficient in some cases.
Spondylitis
Ankylosing spondylitis (AS) is a type of arthritis that causes inflammation in the spine; it’s more common in people aged 17 to 35 and is believed to be caused, in part, by genetics.
You can understand ankylosing spondylitis, in part, by defining each part of the term:
- Ankylosing means stiffness of a joint
- Spondy means spinal column or spine
- Itis means inflammation
Ankylosing spondylitis, then, is spinal inflammation that leads to stiffness. Typically, AS starts with inflammation in the sacroiliac joints, which connect your spine to your pelvis—as such, AS usually starts as a low back disease. Over time, AS can cause the vertebrae of the spine to fuse together, creating a hunched posture. In some cases, the ribs will be affected, which can cause it to be difficult to breathe.
AS can lead to chronic pain in the neck, shoulders, back, hips, thighs, and limbs. Patients may also experience poor posture and chronic fatigue as a result of AS. In some cases of AS, eye inflammation (called uveitis), compression fractures, and heart problems can occur. These conditions are quite severe—early diagnosis of AS can help limit the possibility of developing serious complications.
Diagnosing and Treating Spondylitis
Your doctor may conduct a variety of tests to diagnose spondylitis, including:
- Range of motion tests
- Palpitations around your pelvis and sacroiliac joints
- A deep breath test to see if your ribcage is affected
- Imaging tests, including X-rays and MRIs
- Blood tests to check for markers of inflammation
Ankylosing spondylitis can cause irreversible damage to your spine, hips, and other parts of your body. There is no cure, but several treatment options are available. These treatments can dramatically reduce the impact of AS and stop it from causing serious damage. They include:
- The use of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen
- Tumor necrosis factor (TNF) blockers
- Interleukin-17 inhibitors
- Janus kinase inhibitors
- Physical therapy
AS cannot be treated with surgery, but some of its consequences can be. If a hip, for example, has been damaged by AS; a hip replacement surgery could help. Wherever possible, however, the use of conservative treatment to limit the effects of AS is best.
Outcomes
Outcomes for spondylosis, spondylitis, and spondylolisthesis vary considerably depending on the condition. Spondylosis and spondylolisthesis can be so subtle that patients never experience symptoms; spondylitis, on the other hand, almost always leads to symptoms.
Patients with any (or even all) of these conditions can see drastic improvements through treatment. One of the keys to treatment for any of these conditions is catching them early, so it’s always a good idea to visit your doctor regularly—especially if you’re experiencing back pain, numbness, loss of motion, or other symptoms.
Whether you opt for non-surgical interventions or surgery will depend, in part, on the severity of the condition. Minimally invasive spine surgery is becoming the norm, and the outcomes for all of these conditions are much better now than they once were.
Conclusion
Concerned about spondylosis, spondylitis, or spondylolisthesis? The spinal surgeons at the New Jersey Spine Institute are here to help. We offer a range of treatments for all of these conditions, including medications, injections, and surgical interventions—including minimally invasive spinal fusion surgery.
Our two-surgeon approach can help treat even the most severe spinal conditions. Get in touch with us today.