Spondylolisthesis Symptoms and Treatment
In spondylolisthesis, one of the bones in your spine — called a vertebra — slips forward and out of place. This may occur anywhere along the spine, but is most common in the lower back (lumbar spine). In some people, this causes no symptoms at all. Others may have back and leg pain that ranges from mild to severe.
Spondylolisthesis FAQ
What Causes Spondylolisthesis?
There are multiple types of spondylolisthesis, with **degenerative** and **spondylolytic** being the most common. Less common types include slippage caused by severe fractures or tumors.
Degenerative Spondylolisthesis
As the spine ages, **intervertebral discs weaken and shrink**, leading to arthritis and instability. This can cause vertebrae to slip forward, potentially **narrowing the spinal canal** (spinal stenosis).
Spondylolytic Spondylolisthesis
Caused by a **stress fracture** in the pars interarticularis, a small section of bone in the vertebra. Over time, the fracture weakens and may lead to vertebral slippage, commonly seen in middle-aged men.
What Are the Symptoms of Spondylolisthesis?
Many people with spondylolisthesis have **no symptoms**. However, when symptoms develop, they may include:
Degenerative Spondylolisthesis Symptoms
- **Leg pain and weakness** (due to spinal nerve compression)
- **Lower back pain** aggravated by prolonged standing or walking
- **Numbness or tingling** in the legs
- Symptoms improve when **bending forward** or sitting
Spondylolytic Spondylolisthesis Symptoms
- **Lower back pain** that worsens with activity
- Occasional **leg pain**
- May be **asymptomatic and discovered on X-ray**
What Are the Treatment Options for Spondylolisthesis?
Nonsurgical Treatment
Although nonsurgical treatments cannot reverse the slippage, they may **relieve symptoms** and improve mobility.
Physical Therapy & Exercise
Strengthening **core muscles** and improving flexibility may help stabilize the spine.
Medications
**NSAIDs** (ibuprofen, naproxen) and **analgesics** can help manage pain and inflammation.
Steroid Injections
Cortisone injections **reduce inflammation** around irritated nerves. However, they are **limited to three times per year**.
Surgical Treatment
Surgery is reserved for patients who **do not improve after 3-6 months** of conservative treatment or have severe **nerve compression**.
Decompression Surgery (Laminectomy)
Removes bone to **relieve nerve pressure** in cases of spinal stenosis.
Spinal Fusion
A "welding" procedure where **two vertebrae are fused** together to prevent movement and slippage. Often supported with screws or rods.