Table of ContentsView AllTable of ContentsTypes of SpondylolisthesisSymptomsCausesDiagnosisTreatmentFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Types of Spondylolisthesis
Symptoms
Causes
Diagnosis
Treatment
Frequently Asked Questions
Spondylolisthesisis a condition in which avertebrain the lumbar (lower) spine slips out of normal position, sliding forward (or sometimes backward) relative to the vertebra beneath it. It can be the result of an injury, lower back stress associated with sports, or age-related changes in the spine.
Spondylolisthesis usually is diagnosed with anX-ray. Low-grade spondylolisthesis may be relieved with non-invasive measures, while more severe cases may require a surgical procedure.
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The vertebrae are the box-shaped bones stacked on top of each other that make up the spinal column. Each vertebra should be neatly stacked on the one above and below. The spinal column has a normal S-shaped curvature when viewed from the side, but each vertebra should be neatly positioned on top of the vertebra below.
In spondylolisthesis, the vertebrae shift from their normal position. As a result, the condition is often referred to as “slipped vertebrae.” Forward slippage is calledanterolisthesisand backward slippage is calledretrolisthesis.
Most often, this is a very slowly progressive condition with different types that include:
Less common forms of the condition include:
Many people with spondylolisthesis have no obvious symptoms. Sometimes the condition is not discovered until an X-ray is taken for an unrelated injury or condition.
The most common symptom is lower back pain that can radiate to the buttocks and down the backs of the thighs.The symptoms may get worse during activity and subside during rest. Specifically, you may find that symptoms disappear when you bend forward or sit and get worse when you stand or walk.
This is because sitting and bending open up the space where spinal nerves are located, relieving pressure. Other potential symptoms include:
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Children involved in sports such as gymnastics, football, and diving tend to be at an increased risk for isthmic spondylolisthesis.These sports require repeated spinalhyperextension, which can cause a stress fracture of thepars interarticularisin the L5 vertebra.
Unless the hyperextension exercises are stopped to give the bone time to heal, scar tissue can form and prevent the bones from ever healing properly. This can lead to spondylolysis or stress fractures in the pars interarticularis, a condition that commonly leads to spondylolisthesis.
It’s possible to be born with spondylolysis or spondylolisthesis, but both conditions can also develop from an injury, a disease, or a tumor.
Genetics may play a role in the risk of spondylolisthesis. There have been higher reports of spondylolisthesis in certain ethnic groups, namely Inuit Eskimos and Black Americansassigned female at birth.
Degenerative spondylolisthesis, the most common type, tends to affect adults over the age of 40. Older age, female gender, being overweight or obese,and conditions that can affect the spine, such asdegenerative disc disease (DDD)andosteoarthritis, are thought to be factors that elevate the risk for this condition.
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A healthcare professional will first talk to you and/or your child about symptoms, medical history, general health, and any participation in sports or physical activities. Then, they will examine the spine, looking for areas of tenderness or muscle spasms, and assess whether there are problems with gait or posture.
Next, your practitioner may order imaging studies, including:
There are five spondylolisthesis grades, each representing an incremental 25% increase of slippage in the vertebra.
Spondylolisthesis gradeDegree of slippageGrade I0%—25%Grade II25%—50%Grade III51%—75%Grade IV76%—100%Grade V101% or moreTreatmentSpondylolisthesis is treated according to the grade. For grades I and II, conservative treatments are often sufficient, includingnonsteroidal anti-inflammatory drugs (NSAIDs)such as ibuprofen, physical therapy, home exercises, stretching, and the use of a brace.In physical therapy,core strengthening and stabilizationexercises are emphasized.Over the course of treatment, periodic X-rays may be taken to determine whether the vertebra is changing position.For high grades or progressive worsening,spinal fusion surgerymay be recommended.During this procedure, the affected vertebrae are fused together so that they heal into a single, solid bone.During the procedure, the surgeon will realign the vertebrae in the lumbar spine. Small pieces of bone—called a bone graft—are then placed into the spaces between the vertebrae to be fused. Over time, the bones grow together, much like when a broken bone heals. Metal screws and rods may be installed to further stabilize the spine and improve the chances of successful fusion.In some cases, patients with high-grade slippage also have compression of the spinal nerve roots. If this is the case, a procedure known as spinal decompression can help open up the spinal canal and relieve pressure on the nerves.Should You Have Disc Replacement Surgery or a Spinal Fusion?SummarySpondylolisthesis is a spine condition in which a vertebra slips out of position. This may cause symptoms like low back pain and back stiffness. Young athletes are often at increased risk for spondylolisthesis as overextending the spine—which commonly happens in sports like football and gymnastics—is one of the most common causes of the condition.To diagnose spondylolisthesis, a healthcare professional will review a person’s symptoms and medical history, and they’ll use imaging tests like X-rays and CT scans to analyze the spine and determine the severity, or grade, of the problem.Lower-grade cases of spondylolisthesis typically respond well to conservative treatment like anti-inflammatory medication and physical therapy, while higher-grade cases may require surgery.In most cases, it’s possible to resume activities, including sports, once the condition has been treated. If symptoms reappear after treatment, tell a healthcare provider so that they can determine what strategies are needed to relieve them and restore your quality of life.Frequently Asked QuestionsSpondylosis is a condition in which there is a stress fracture or weakness in a vertebra. Spondylolisthesis occurs when a vertebra slips out of position. Spondylosis may lead to spondylolisthesis, as a fracture in a vertebra may cause it to slip.If you have spondylolisthesis, you may qualify for disability insurance if symptoms are severe and greatly impact your quality of life.Those with spondylolisthesis should avoid movements that put great stress on the spine, such as lifting heavy objects. They should also avoid participating in sports that can lead to overtwisting or overextending the spine, like gymnastics and wrestling, until after treatment.
Spondylolisthesis is treated according to the grade. For grades I and II, conservative treatments are often sufficient, includingnonsteroidal anti-inflammatory drugs (NSAIDs)such as ibuprofen, physical therapy, home exercises, stretching, and the use of a brace.In physical therapy,core strengthening and stabilizationexercises are emphasized.
Over the course of treatment, periodic X-rays may be taken to determine whether the vertebra is changing position.
For high grades or progressive worsening,spinal fusion surgerymay be recommended.During this procedure, the affected vertebrae are fused together so that they heal into a single, solid bone.
During the procedure, the surgeon will realign the vertebrae in the lumbar spine. Small pieces of bone—called a bone graft—are then placed into the spaces between the vertebrae to be fused. Over time, the bones grow together, much like when a broken bone heals. Metal screws and rods may be installed to further stabilize the spine and improve the chances of successful fusion.
In some cases, patients with high-grade slippage also have compression of the spinal nerve roots. If this is the case, a procedure known as spinal decompression can help open up the spinal canal and relieve pressure on the nerves.
Should You Have Disc Replacement Surgery or a Spinal Fusion?
Summary
Spondylolisthesis is a spine condition in which a vertebra slips out of position. This may cause symptoms like low back pain and back stiffness. Young athletes are often at increased risk for spondylolisthesis as overextending the spine—which commonly happens in sports like football and gymnastics—is one of the most common causes of the condition.
To diagnose spondylolisthesis, a healthcare professional will review a person’s symptoms and medical history, and they’ll use imaging tests like X-rays and CT scans to analyze the spine and determine the severity, or grade, of the problem.
Lower-grade cases of spondylolisthesis typically respond well to conservative treatment like anti-inflammatory medication and physical therapy, while higher-grade cases may require surgery.
In most cases, it’s possible to resume activities, including sports, once the condition has been treated. If symptoms reappear after treatment, tell a healthcare provider so that they can determine what strategies are needed to relieve them and restore your quality of life.
Frequently Asked QuestionsSpondylosis is a condition in which there is a stress fracture or weakness in a vertebra. Spondylolisthesis occurs when a vertebra slips out of position. Spondylosis may lead to spondylolisthesis, as a fracture in a vertebra may cause it to slip.If you have spondylolisthesis, you may qualify for disability insurance if symptoms are severe and greatly impact your quality of life.Those with spondylolisthesis should avoid movements that put great stress on the spine, such as lifting heavy objects. They should also avoid participating in sports that can lead to overtwisting or overextending the spine, like gymnastics and wrestling, until after treatment.
Spondylosis is a condition in which there is a stress fracture or weakness in a vertebra. Spondylolisthesis occurs when a vertebra slips out of position. Spondylosis may lead to spondylolisthesis, as a fracture in a vertebra may cause it to slip.
If you have spondylolisthesis, you may qualify for disability insurance if symptoms are severe and greatly impact your quality of life.
Those with spondylolisthesis should avoid movements that put great stress on the spine, such as lifting heavy objects. They should also avoid participating in sports that can lead to overtwisting or overextending the spine, like gymnastics and wrestling, until after treatment.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cleveland Clinic.Spondylolisthesis.Cedars Sinai.Spondylolisthesis.American Academy of Orthopaedic Surgeons.Spondylolysis and spondylolisthesis.NYU Langone Health.Diagnosing spondylolisthesis in adults.Wang YXJ, Káplár Z, Deng M, Leung JCS.Lumbar degenerative spondylolisthesis epidemiology: A systematic review with a focus on gender-specific and age-specific prevalence.J Orthop Translat. 2016;11:39-52. doi:10.1016/j.jot.2016.11.001Tedyanto EH.Relationship between body mass index and radiological features of spondylolisthesis.International Journal of Science and Research.2020;9(2):2319-7064. doi:10.21275/SR20215210921Koslosky E, Gendelberg D.Classification in brief: The Meyerding classification system of spondylolisthesis.Clin Orthop Relat Res. 2020;478(5):1125-1130. doi:10.1097/CORR.0000000000001153American Academy of Orthopaedic Surgeons.Spinal fusion.Cleveland Clinic.Spondylolysis.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cleveland Clinic.Spondylolisthesis.Cedars Sinai.Spondylolisthesis.American Academy of Orthopaedic Surgeons.Spondylolysis and spondylolisthesis.NYU Langone Health.Diagnosing spondylolisthesis in adults.Wang YXJ, Káplár Z, Deng M, Leung JCS.Lumbar degenerative spondylolisthesis epidemiology: A systematic review with a focus on gender-specific and age-specific prevalence.J Orthop Translat. 2016;11:39-52. doi:10.1016/j.jot.2016.11.001Tedyanto EH.Relationship between body mass index and radiological features of spondylolisthesis.International Journal of Science and Research.2020;9(2):2319-7064. doi:10.21275/SR20215210921Koslosky E, Gendelberg D.Classification in brief: The Meyerding classification system of spondylolisthesis.Clin Orthop Relat Res. 2020;478(5):1125-1130. doi:10.1097/CORR.0000000000001153American Academy of Orthopaedic Surgeons.Spinal fusion.Cleveland Clinic.Spondylolysis.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Cleveland Clinic.Spondylolisthesis.Cedars Sinai.Spondylolisthesis.American Academy of Orthopaedic Surgeons.Spondylolysis and spondylolisthesis.NYU Langone Health.Diagnosing spondylolisthesis in adults.Wang YXJ, Káplár Z, Deng M, Leung JCS.Lumbar degenerative spondylolisthesis epidemiology: A systematic review with a focus on gender-specific and age-specific prevalence.J Orthop Translat. 2016;11:39-52. doi:10.1016/j.jot.2016.11.001Tedyanto EH.Relationship between body mass index and radiological features of spondylolisthesis.International Journal of Science and Research.2020;9(2):2319-7064. doi:10.21275/SR20215210921Koslosky E, Gendelberg D.Classification in brief: The Meyerding classification system of spondylolisthesis.Clin Orthop Relat Res. 2020;478(5):1125-1130. doi:10.1097/CORR.0000000000001153American Academy of Orthopaedic Surgeons.Spinal fusion.Cleveland Clinic.Spondylolysis.
Cleveland Clinic.Spondylolisthesis.
Cedars Sinai.Spondylolisthesis.
American Academy of Orthopaedic Surgeons.Spondylolysis and spondylolisthesis.
NYU Langone Health.Diagnosing spondylolisthesis in adults.
Wang YXJ, Káplár Z, Deng M, Leung JCS.Lumbar degenerative spondylolisthesis epidemiology: A systematic review with a focus on gender-specific and age-specific prevalence.J Orthop Translat. 2016;11:39-52. doi:10.1016/j.jot.2016.11.001
Tedyanto EH.Relationship between body mass index and radiological features of spondylolisthesis.International Journal of Science and Research.2020;9(2):2319-7064. doi:10.21275/SR20215210921
Koslosky E, Gendelberg D.Classification in brief: The Meyerding classification system of spondylolisthesis.Clin Orthop Relat Res. 2020;478(5):1125-1130. doi:10.1097/CORR.0000000000001153
American Academy of Orthopaedic Surgeons.Spinal fusion.
Cleveland Clinic.Spondylolysis.
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