Spondylolisthesis

What Is Spondylolisthesis?

Spondylolisthesis is a condition of the spine where one of the vertebrae (the bones that make up the spine) slips forward over the one below it. This misalignment can reduce space in the spinal canal, irritate nerves, and lead to pain or other symptoms. It most often occurs in the lower back (lumbar spine) but can also affect the middle or neck regions of the spine.

Causes and Risk Factors

There are several reasons spondylolisthesis can develop:

• Degenerative changes: Age-related wear and tear can weaken the discs and joints, allowing slippage.
• Isthmic defects: A stress fracture in a small part of the vertebra (the pars interarticularis) can lead to slippage.
• Congenital factors: Some people are born with spinal shapes more prone to slippage.
• Trauma: Injuries such as falls or accidents can destabilize the spine.
• Pathological conditions: Diseases that weaken the bones (like osteoporosis or tumors) may contribute.

The condition can affect adults and adolescents alike, and sports or activities that stress the spine may increase risk.

Symptoms to Watch For

Many people with spondylolisthesis have no symptoms at all, especially in mild cases. But when symptoms do occur, they may include:

• Lower back pain that may worsen with standing or activity.
• Radiating pain into the buttocks or legs (similar to sciatica).
• Stiffness or muscle tightness in the back.
• Numbness, tingling, or weakness in the legs and feet.
• Difficulty walking or standing for long periods.

Severe nerve compression may rarely lead to symptoms like loss of bladder or bowel control and should prompt immediate medical attention.

Diagnosis

Your provider will start with a thorough medical history and physical examination, followed by imaging tests such as:

• X-rays to view vertebral alignment
• MRI or CT scans to assess nerve compression or soft tissue
• Nerve studies if weakness or numbness is present

Imaging helps determine the degree of vertebral slippage and the best treatment approach.