Understanding Isthmic Spondylolisthesis (Video)

See how isthmic spondylolisthesis, a condition where one vertebra slips forward over the vertebra below it, can cause lower back or leg pain.

Source: Isthmic Spondylolisthesis Video

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Understanding low back pain

It is important for a patient to understand what are the causes of low back pain and how it is treated. Many patients who suffer from chronic low back pain have irrational fear of harming their back. This prevents them from leading an active lifestyle and perpetuates the pain cycle. Self knowledge is important to prevent this from happening. Please see this excellent video presentation by Dr. Mike Evans to improve your knowledge about one of the most common problems affecting humans.

 

DEXA scan (Bone Densitometry)

What is DEXA scan or Bone mineral densitometry (BMD)?

DEXA scan (dual energy x-ray absorptiometry) or bone mineral densitometry (BMD) uses a special type of X-ray to measure your bone density. Reduced bone density can lead to the weakening of bones and fractures. This condition is called osteoporosis and is more common in women after menopause. DEXA scan is the best available test for the diagnosis of osteoporosis and used to predict the risk of fracture. 

Preparation for the test

Do not take calcium or vitamin tablets before the procedure

Who should be tested?

  • Anyone with a  previous fracture caused by normal activities or following a trivial fall.
  • All women older than 65 and men older than 70
  • Postmenopausal women between 50 and 65, with risk factors for osteoporosis
  • Men aged 50 to 69, with risk factors for osteoporosis 
Risk factors:
  1. Thin build (body weight less than 127 pounds or 58 kg, body mass index less than 21)
  2. Parent with a hip fracture
  3. Current smoker
  4. Alcohol intake more than 3 drinks on most days
  5. Rheumatoid arthritis
  6. Early menopause

When should you be retested?

A repeat test is indicated when it is likely to influence your clinical management. Consider repeating the test in one to two years if your doctor as started medications to treat your osteoporosis. Depending on some preexisting risk factors, your doctor may advise you to undergo repeat testing even sooner.  You should discuss this with your doctor. If your first test was normal, you should wait at least 2 years or more before repeating the test.

Meaning of the test results

The test results are reported in T and Z scores. T score compares your current bone density with that of a normal, healthy young adult population of the same gender. T score is used to define osteoporosis in postmenopausal women. Z score compared your current bone density with that of a population of the same age, gender and race. Z scores are useful in premenopausal women under the age of 50.
 
  • Normal: less than a standard deviation below normal (greater than -1).
  • Osteopenia:1 to 2.5 standard deviations below normal (-1 to -2.5).
  • Osteoporosis: greater than 2.5 standard deviations below normal (less than -2.5)
Discuss your test results with your doctor. The doctor will use this information, along with other parameters to determine your fracture risk. If you already have been diagnosed with osteoporosis, DEXA is useful to monitor the progress of your treatment.