Spondylolisthesis

Overview

Spondylolisthesis occurs when one vertebra slips forward over the one below it. This condition most often affects the lower back (lumbar spine) and can lead to pain and nerve compression.

The severity can range from mild slippage with no symptoms to more significant displacement that affects nerves and stability of the spine.

Urban Spine and Joint

Symptoms

Symptoms depend on how much the vertebra has shifted and whether nerves are affected.

Common symptoms include:

  1. Lower back pain
  2. Stiffness in the back
  3. Muscle spasms
  4. Pain that may radiate into the legs
  5. Numbness or tingling in the legs
  6. Weakness in the legs

Severe cases may cause cauda equina syndrome, which includes loss of bowel or bladder control and requires urgent treatment.

Causes

Spondylolisthesis can develop from several underlying conditions.

Common causes include:

  1. Congenital spine abnormalities
  2. Stress fractures of the vertebrae (spondylolysis)
  3. Spine injuries or trauma
  4. Degenerative changes with aging
  5. Repetitive stress from sports such as football, gymnastics, or weightlifting
  6. Tumors or prior spine surgery

These factors can weaken the spine and allow vertebrae to shift.

Diagnosis

Diagnosis begins with a medical history and physical examination. A doctor will assess pain, movement, and nerve function.

Imaging tests may include:

  1. X-rays (including standing and bending views) to detect slippage
  2. MRI scans to evaluate nerve compression and soft tissues
  3. CT scans for detailed bone imaging
  4. CT myelograms to assess pressure on nerves

These tests help determine the severity and guide treatment.

Treatment Options

Most cases are treated with non-surgical care.

Common treatment options include:

  1. Rest and activity modification
  2. Back bracing
  3. Physical therapy
  4. Pain medications and muscle relaxants
  5. Chiropractic care

If symptoms persist, epidural steroid injections may be used to reduce inflammation around nerves.

Surgery may be required in severe cases, especially with nerve compression or spinal instability. Procedures may include decompression (laminectomy) or spinal fusion to stabilize the spine.

When to Seek Evaluation

Persistent lower back pain, neck pain, or radiating nerve pain should not be ignored. Early evaluation allows for proper diagnosis and targeted treatment, helping prevent progression and long-term complications.