Spondylolisthesis is a condition in which one of the bones of the spine (vertebrae) slips out of place onto the vertebra below it. If it slips too much, the bone might press on a nerve, causing pain. Usually, the bones of the lower back are affected.
The word spondylolisthesis comes from the Greek words spondylos, which means “spine” or “vertebra,” and listhesis, which means “to slip or slide.”
There are different types of spondylolisthesis. The more common types include:
Less common forms of spondylolisthesis include:
Spondylolisthesis is the most common cause of back pain in teens. Symptoms of spondylolisthesis often begin during the teenage growth spurt. Degenerative spondylolisthesis occurs most often after age 40.
Many people with spondylolisthesis have no symptoms and don’t even know they have the condition. When symptoms do occur, low back pain is the most common. The pain usually spreads across the lower back, and might feel like a muscle strain.
Spondylolisthesis can also cause muscle spasms in the hamstring muscles in the back of the thighs. Tight hamstrings can cause the person to walk with short strides and with the knees slightly bent. If the slipped vertebra is pressing on a nerve, pain might spread down the leg to the foot. The foot might also tingle and/or feel numb.
A radiologist determines the degree of slippage upon reviewing spinal X-rays. Slippage is graded I through IV:
Generally, Grade I and Grade II slips do not require surgical treatment and are treated medically. Grade III and Grade IV slips might require surgery if persistent, painful, slips are present.
An X-ray of the lower back can show a vertebra out of place. A computed tomography (CT) or magnetic resonance imaging (MRI) scan — which produce more detailed images — might be needed to more clearly see the bones and nerves involved.
Treatment for spondylolisthesis depends on several factors, including the age and overall health of the person, the extent of the slip, and the severity of the symptoms. Treatment most often is conservative, involving rest, medication, and exercise. More severe spondylolisthesis might require surgery.
A brace or back support might be used to help stabilize the lower back and reduce pain. A program of exercise and/or physical therapy will help increase pain-free movement, and improve flexibility and muscle strength. Periodic X-rays are done to determine if the bone slippage is continuing.
Persistent pain associated with spondylolisthesis can lead to reduced mobility and inactivity. Inactivity can, in turn, result in weight gain, loss of bone density, and loss of muscle strength and flexibility in other areas of the body. There is also a risk of permanent nerve damage if a slipped vertebra is pressing on a spinal nerve root.
The chance of having a recurrence of pain depends on the severity of the spondylolisthesis. In the case of a minor slip, where the bone is not pressing on any nerves, the person might never have a recurrence of back pain related to spondylolisthesis.
In general, conservative treatment for mild cases of spondylolisthesis is successful in about 80 percent of cases. Surgery is successful in relieving symptoms in 85 percent to 90 percent of people with severe spondylolisthesis.
Although spondylolisthesis might not be preventable, there are steps you can take to reduce the risk of slips:
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition.
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