Spondylolisthesis happens when one of your vertebrae (spinal bones) shifts on the vertebrae below it.
This causes an irregular stacking of the bones.
This can happen for a multitude of reasons: due to wear and tear (degeneration), trauma, bone defects, etc.
This can cause mechanical back pain (due to the disc and muscles), nerve irritation, or spinal cord problems.
Diagnosis
The success of treatment options depend on an accurate diagnosis, using a combination of but not limited to: physical exam, x-ray, CT scan, MRI, diagnostic injections, and EMG investigation.
Treatment
Treatment options include therapy, core strengthening, weight loss, injections, surgical decompression, or surgical fusion. All treatment options depend on the type of spondylolisthesis and a custom treatment plan is recommended for each and every patient.
FAQs
Spondylolisthesis
1. What is spondylolisthesis?
Spondylolisthesis is a condition where one vertebra slips forward over the one below it. It can cause back/neck pain, arm/leg pain, or sometimes no symptoms at all.
2. What causes spondylolisthesis?
It can be caused by:
Congenital (dysplastic) defects from birth
Isthmic (stress fractures in the pars interarticularis)
Degenerative changes due to aging and arthritis
Trauma
Post-surgical instability
3. What are the symptoms?
Lower back/neck pain
Stiffness
Tight hamstrings
Pain, numbness, or tingling down the arms/legs (sciatica)
In severe cases, weakness or difficulty walking
4. How is spondylolisthesis diagnosed?
Usually through:
Physical examination
X-rays (to see vertebral slippage)
MRI or CT scan (to evaluate nerves and spinal canal)
5. What are the treatment options?
Non-surgical:
Physical therapy
Anti-inflammatory medications
Activity modification
Bracing (sometimes)
Injections (epidural steroid injections)
Surgical (if symptoms persist or worsen):
Decompression (free nerves by taking out tissue/bone)
Spinal fusion
6. Will I need surgery?
Not Always. Many people improve with conservative treatment. Surgery is usually considered if:
Conservative treatments fail
Symptoms are severe or progressive
Nerve compression causes significant leg symptoms or weakness
There's significant vertebral instability
7. Can I still exercise or play sports?
Yes, depending on the severity and symptoms. Low-impact activities like walking, swimming, and core strengthening are usually encouraged. High-impact sports may need to be limited, especially with higher-grade slips.
8. What is the recovery time after surgery?
Hospital stay: typically 1–2 days
Return to light activity: 1-2 weeks weeks
Full recovery: up to 6 months or more, depending on the severity, procedure, and patient health
9. Is spondylolisthesis permanent?
The structural change (vertebral bone slippage) is usually permanent, but symptoms can often be managed effectively. Surgery may stabilize the area if needed.
10. What’s the difference between spondylosis, spondylolysis, and spondylolisthesis?
Spondylosis = Age-related degenerative spine changes
Spondylolysis = Stress fracture in the pars interarticularis
Spondylolisthesis = One vertebra slipping forward over another