Spondylolisthesis

Spondylolisthesis is a condition of the lower spine in which one vertebra slips out of position and moves in front of or behind the vertebra below. It may cause lower back pain that radiates into the buttocks and legs, along with stiffness, tingling, or numbness that worsens with standing or walking.

At Hoag Orthopedic Institute, our board-certified and fellowship-trained spine specialists provide personalized spondylolisthesis care to relieve pain, restore stability, and address the underlying cause so you can get back to you.

What Is Spondylolisthesis?

Spondylolisthesis occurs when one vertebra slips out of position and slides in front of or behind the vertebra below. It most often occurs in the lumbar or sacral region of the spine (lower back), and can place pressure on nearby nerves or the spinal cord.

Spondylolisthesis-related nerve compression can lead to lower back pain, weakness, or numbness, as well as pain radiating into the buttock and leg (sciatica). As the condition progresses, it can affect walking, strength, or coordination.

Types of Spondylolisthesis

Spondylolisthesis is classified based on the underlying cause of vertebral slippage. The two most common types are degenerative (from aging) and isthmic (resulting from stress fractures). Identifying the type helps guide treatment and long-term management.

Common types of spondylolisthesis include:

• Degenerative spondylolisthesis: The most common form typically affects adults over age 50. It develops as the joints and discs in the spine wear down over time, allowing one vertebra to slip forward.
• Isthmic spondylolisthesis: Caused by a stress fracture or defect in a part of the vertebra called the pars interarticularis. This type often begins in adolescence and may progress into adulthood.
• Congenital spondylolisthesis: Present at birth due to abnormal spinal formation. The structure of the vertebrae may allow slippage to occur more easily over time.
• Traumatic spondylolisthesis: Results from an acute injury or fracture that disrupts the alignment of the spine.
• Pathologic spondylolisthesis: Occurs when a disease process, such as a tumor or infection, weakens the bone and leads to vertebral slippage.
• Iatrogenic (post-surgical) spondylolisthesis: May occur after spinal surgery when structural support of the spine is reduced.

What are the Causes of Spondylolisthesis?

Spondylolisthesis causes vary depending on the type, but all involve a loss of normal spinal stability that allows one vertebra to slip out of position. It may be caused by congenital conditions affecting joints, infection, or arthritis, as well as accidents, trauma, and overuse that lead to stress fractures or herniated discs.

Spondylolysis is relatively common in children (10 to 15 years old) and young adults who participate in sports where there is repetitive stress on the lower back, such as football, weightlifting, and gymnastics. This type of stress can lead to stress fractures in the vertebrae, which may contribute to spondylolisthesis.

Common causes of spondylolisthesis include:

• Age-related degeneration
• Stress fractures or defects
• Congenital abnormalities
• Trauma or acute injury
• Diseases
• Post-surgical instability

What are the Signs and Symptoms of Spondylolisthesis?

Spondylolisthesis symptoms can vary depending on the degree of slippage and nerve involvement. Some people may not notice symptoms at first, while others experience persistent lower back and leg pain that limits their activity level.

Common signs of spondylolisthesis include:

• Lower back pain
• Radiating pain down into the buttock and into the leg (sciatica)
• Weakness or numbness in the buttocks or legs
• Difficulty standing or walking for extended periods
• Muscle tightness or stiffness in the lower back
• Reduced range of motion

In more advanced cases, nerve compression can lead to significant weakness, difficulty with coordination, or loss of bladder or bowel control.

How is Spondylolisthesis Diagnosed?

Spondylolisthesis is diagnosed through a physical examination and imaging studies. Your doctor evaluates your symptoms, spinal alignment, range of motion, strength, and nerve involvement. X-rays can confirm vertebral slippage and assess severity. If you are referred to an orthopedic spine surgeon, they may order an MRI to evaluate nerve compression or soft tissue involvement related to the severity of your spondylolisthesis.

Treatment for Spondylolisthesis

Spondylolisthesis treatment may begin with non-surgical care, such as rest, bracing to immobilize the spine, physical therapy to strengthen the back muscles, and pain management (such as epidural steroid injections).

If non-surgical treatment fails to relieve pain or improve motion, or when slippage is severe, back surgery may be required. Surgical treatment often includes a decompressive laminectomy to relieve pressure on the nerve roots or spinal cord. Spinal fusion may be used to join vertebrae in the spine and provide stabilization of the affected area.

Most patients make a full recovery following spondylolisthesis treatment and are pain-free and able to return to sports and other activities gradually over time.

Why Choose Hoag Orthopedic Institute for Spondylolisthesis

At Hoag Orthopedic Institute, helping patients improve mobility, relieve pain, and return to an active and healthy life is always our top objective.

Our board-certified, fellowship-trained specialists take a multi-disciplinary approach to spondylolisthesis care, guiding your treatment, addressing the underlying condition, and supporting your recovery.

Find a spine doctor today by browsing our online
physician directory.