Spondylolisthesis is a spinal condition that causes lower back pain. It occurs when one of your vertebrae, the bones of your spine, slips out of place onto the vertebra below it. Most of the time, nonsurgical treatment can relieve your symptoms. If you have severe spondylolisthesis, surgery is successful in most cases.
Spondylolisthesis is a condition involving spine instability, which means the vertebrae move more than they should. A vertebra slips out of place onto the vertebra below. It may put pressure on a nerve, which could cause lower back pain or leg pain.
The word spondylolisthesis (pronounced spohn-di-low-less-THEE-sis) comes from the Greek words spondylos, which means "spine" or "vertebra," and listhesis, which means "slipping, sliding or movement."
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Both spondylolysis and spondylolisthesis cause low back pain. They are related but not the same.
Types of spondylolisthesis include:
Less common types of spondylolisthesis include:
Spondylolisthesis and spondylolysis occur in about 4% to 6% of the adult population. It’s possible to live with spondylolisthesis for years and not know it, since you may not have symptoms.
Degenerative spondylolisthesis (which occurs due to aging and wear and tear on the spine), is more common after age 50 and more common in women than men.
When back pain occurs in teens, isthmic spondylolisthesis (usually caused by spondylolysis) is one of the most common causes.
You may be more likely to develop spondylolisthesis due to:
To determine how severe spondylolisthesis is, your healthcare provider gives it a grade:
Your healthcare provider will start with nonsurgical options, such as rest and physical therapy. These treatments often relieve symptoms. Your healthcare provider may recommend surgery if you:
Overextending the spine is one of the main causes of spondylolisthesis in young athletes. Genetics may play a role, too. Some people are born with thinner vertebral bone. In older adults, wear and tear on the spine and disks (the cushions between vertebrae) can cause this condition.
You may not experience any symptoms of spondylolisthesis. Some people have the condition and don’t even know it. If you do have symptoms, lower back pain is typically the main one. The pain may extend to the buttocks and down the thighs. You may also experience:
Your healthcare provider will do a physical exam and ask you about your symptoms. You will then likely need an imaging scan to confirm the diagnosis.
Treatment depends on the grade of the slippage, your symptoms, age and overall health. Your healthcare provider will discuss treatment options with you. You may need medication, physical therapy or surgery.
Nonsurgical treatments include:
You may need surgery if you have high-grade spondylolisthesis, the pain is severe or you’ve tried nonsurgical treatments without success. The goals of spondylolisthesis surgery are to:
Surgery for back pain due to spondylolisthesis typically involves spinal decompression, with or without fusion. Decompression alone is almost never done in isthmic spondylolisthesis. Studies show fusion with decompression may give better outcome than decompression alone. During a decompression surgery, your surgeon removes bone and disk from the spine. This procedure gives the nerves space inside the spinal canal, relieving pain.
For a fusion surgery, your surgeon fuses (connects) the two affected vertebrae. As they heal, they form into one bone, eliminating movement between the two vertebrae. You may experience some limited spinal flexibility as a result of the surgery.
Most of the time, pain is gone after you recover from spondylolisthesis surgery. You can gradually begin to resume your activities until you are back to full function and movement.
You can take steps to reduce your risk of spondylolisthesis:
Your healthcare provider may recommend exercises to strengthen the back and abdominal muscles, especially for children. Make sure to have regular checkups so your healthcare provider can detect any problems early on.
The chances of spondylolisthesis coming back, or recurring, are higher if the grade was higher. For people with a minor slippage, the condition may never come back.
Surgery has a high success rate. People who have surgery for spondylolisthesis often return to an active life within a few months of surgery. You will likely need rehabilitation after surgery to help you get back to full function.
While the condition won’t go away on its own, you can often experience relief through rest, medication and physical therapy.
Nonsurgical treatments cannot undo the crack or slippage, but they can provide long-term pain relief. Surgery can relieve pressure on the nerves, stabilize the vertebrae and restore your spine’s strength.
First, take a break from strenuous activity and exercise. Try over-the-counter medications to relieve pain and inflammation. And make sure to see your healthcare provider, who can help you figure out next steps.
A note from Cleveland Clinic
Spondylolisthesis is a common cause of back pain, but it is not dangerous and doesn’t need to take over your life. Many treatments are available, from medication and physical therapy to spinal surgery. If you have low back pain or find it difficult to walk, stand or bend over, talk to your healthcare provider to find out how you can feel better.
Last reviewed by a Cleveland Clinic medical professional on 08/07/2020.
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