Spondylolisthesis

WHAT is

Spondylolisthesis

Spondylolisthesis is a condition in which one of the bones in the lower spine (vertebra) slips forward over the bone below it. This often occurs after a small crack develops on both sides of a vertebra, a condition called spondylolysis, typically due to repeated stress or overuse. The slipping vertebra can stretch the disc below it, potentially causing lower back pain, stiffness, or nerve-related symptoms.

Causes

Common Causes

  • Spondylolysis: Stress fractures in the vertebra from repetitive activities, especially in active children and teens (e.g., gymnasts, football players)
  • Degenerative Changes: Age-related wear and tear on discs and joints
  • Injury or Trauma: Sudden impacts or accidents affecting the spine
  • Congenital: Rarely, abnormal spinal formation present at birth
  • Postural or Mechanical Factors: Muscle imbalances or abnormal spinal alignment

SYMPTOMS

Symptoms to Watch For

  • Lower back pain or stiffness
  • Pain that may radiate into the buttocks or legs
  • Muscle tightness in the hamstrings
  • Difficulty standing or walking for long periods
  • In severe cases, nerve symptoms such as numbness, tingling, or weakness in the legs

Diagnosis

How It’s Diagnosed

Doctors diagnose spondylolisthesis with a physical exam and imaging tests such as X-rays to see vertebral alignment. MRI or CT scans may be ordered to assess nerve involvement, disc health, and severity of slippage.

Treatment Options

Non‑surgical / Lifestyle Approaches:

  • Rest and activity modification to reduce stress on the spine
  • Physical therapy to strengthen core and back muscles
  • Bracing in children or teens to stabilize the spine during growth
  • Pain management with medications or ice/heat therapy

Advanced Treatments:

  • Procedures to stabilize the vertebra and prevent further slippage
  • Spinal fusion may be recommended if conservative treatments fail or neurological symptoms develop