Spondylolisthesis

When one of the bones (vertebrae) in your spine slips out of place, you may be diagnosed with spondylolisthesis. Nerves or nerve roots may be compressed which can cause spondylolisthesis symptoms such as weakness in your legs and pain.

Those most likely to have spondylolisthesis are young people who engage in sports that require extreme back movements such as gymnastics and weightlifting. It can also develop during growth spurts and is a common cause of teenagers’ back pain. Arthritis, wear and tear or a stress fracture are more likely causes of spondylolisthesis symptoms among adults.

When spondylolisthesis affects the lower back, it’s also called lumbar spondylolisthesis. When you have lumbar spondylolisthesis, you may have chronic lower back pain or develop nerve damage.

Types of spondylolisthesis

There are several types of spondylolisthesis including:

• Degenerative spondylolisthesis: Most common form and caused by deterioration of vertebrae.
• Isthmic spondylolisthesis: Caused by spondylolysis – a stress fracture in a vertebra.
• Congenital spondylolisthesis: A birth defect caused by a growth abnormality during pregnancy.
• Traumatic spondylolisthesis: Caused by a trauma to the spine such as a blow or a car crash.
• Pathologic spondylolisthesis: Arises from a bone disease like a spine tumor or osteoporosis.
• Postsurgical spondylolisthesis: Caused by spinal destabilization from a prior surgery.

Grades of spondylolisthesis

Your doctor may describe your condition based on what grade of vertebra misalignment, or slippage, you have. Those grades are:

• Grade 1: Less than 25%
• Grade 2: 25-50%
• Grade 3: 50-75%
• Grade 4: More than 75%

Spondylolisthesis symptoms

Most of the time, spondylolisthesis causes no symptoms. It may only be discovered when imaging is done for another reason. When there are symptoms, they may be few or minor and you may not need spondylolisthesis treatment.

When symptoms develop, they may include:

• Back pain
• Weakness in the legs
• Numbness, pain or a tingling sensation in the thighs or buttocks
• Tenderness in the back
• Overall stiffness

Diagnosis of spondylolisthesis

Spondylolisthesis requires a differential diagnosis, which means your doctor will need to rule out other possible causes of your potential spondylolisthesis symptoms such as spinal stenosis or a herniated disc.

They’ll perform a physical and examine your back. You may be asked to bend in different directions so they can determine if you have pain with motion or a limited range of motion.

Imaging tests like X-ray, CT scans (computed tomography) or MRI (magnetic resonance imaging) may be recommended to show whether one of your spine’s vertebrae has moved out of alignment or whether nerves are likely to be compressed.

Treatment options for spondylolisthesis

Most people find improvement for their symptoms through nonsurgical methods such as resting the back or doing exercises to stretch and strengthen the abdominal and back muscles. Nonsurgical spondylolisthesis treatments include:

• Using a back brace to limit movement
• Taking Pain relievers, such as anti-inflammatory medications (NSAIDs) like ibuprofen or naproxen
• Getting physical therapy to strengthen your abdominal and back muscles
• Corticosteroid injections to reduce inflammation

In severe cases where nonsurgical treatments don’t provide enough relief or if your symptoms get worse over time, your doctor may recommend spinal surgery.

Spondylolisthesis surgery may consist of spinal decompression to ease pressure on the nerves or spinal fusion to stabilize the vertebrae involved.

Your multidisciplinary team of health care providers will work with you to develop an individualized spondylolisthesis treatment plan to meet your needs and get you back to the activities you love.