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Spondylolisthesis is a condition in which one bone in your back (vertebra) slides forward over the bone below it. It most often occurs in the lower spine (lumbosacral area). In some cases, this may lead to your spinal cord or nerve roots being squeezed. This can cause back pain and numbness or weakness in one or both legs. In rare cases, it can also lead to losing control over your bladder or bowels. See a doctor right away if you begin losing bladder or bowel control.
Sometimes when a vertebra slips out of place, you may have no symptoms at all or no symptoms until years later. Then, you may have pain in your low back or buttock. Muscles in your leg may feel tight or weak. You may even limp.
The bones in your spine come together at several small joints that keep the bones lined up while still allowing them to move. Spondylolisthesis is caused by a problem with one or more of these small joints that allows one bone to move out of line.
Spondylolisthesis may be caused by any of a number of problems with the small joints in your back. You could have:
Spondylolisthesis affects children and teenagers involved in sports. Some sports, such as gymnastics or weight lifting, can overuse back bones to the point of causing stress fractures in vertebrae, which can result in spondylolisthesis.
Older adults can develop spondylolisthesis, because wear and tear on the back leads to stress fractures. It can also occur without stress fractures when the disc and joints are worn down and slip out of place.
Symptoms of spondylolisthesis may include:
Sometimes spondylolisthesis causes no symptoms at all.
Your doctor will look at X-rays of your back if he or she suspects you have spondylolisthesis. X-rays will show if any of the vertebrae in your back have fractures or cracks and have slipped out of place. You could also have a CT scan or an MRI to pinpoint the damage and help guide treatment.
Treatment for spondylolisthesis begins with stopping any physical activity that may have led to vertebrae damage. To help relieve pain, ask your doctor if you can take non-steroidal anti-inflammatory drugs, including ibuprofen (such as Advil) or naproxen (such as Aleve). Do not give aspirin to anyone younger than 18 because of the risk of Reye syndrome, a serious illness. Acetaminophen (such as Tylenol) can also help with pain. Be safe with medicines. Read and follow all instructions on the label.
Doctors often suggest physiotherapy to build up stomach and back muscles (core strengthening). In overweight people, weight loss may also help.
When pain is extreme or bones continue to move, or if there is nerve root or spinal cord damage related to the spondylolisthesis, surgery can sometimes help. Surgery may be done to remove bone or other tissue to take pressure off the spinal cord or nerves (decompression). Or surgery may be done to fuse the bones in position. Sometimes both decompression and fusion are done during the same surgery. After any of these surgeries, you may need to wear a cast or back brace for a while. Later, rehabilitation therapy will help make your muscles stronger and movement easier.
Other Works ConsultedKanayama M, et al. (2007). A minimum 10-year follow-up of posterior dynamic stabilization using Graf artificial ligament. Spine, 32(18): 1992–1996.Tay BKB, et al. (2014). Disorders, diseases, and injuries of the spine. In HB Skinner, PJ McMahon, eds., Current Diagnosis and Treatment in Orthopedics, 5th ed., pp. 156–229. New York: McGraw-Hill.
Current as of: March 2, 2020
Author: Healthwise StaffMedical Review: William H. Blahd Jr. MD, FACEP - Emergency MedicineDonald Sproule MDCM, CCFP - Family MedicineAdam Husney MD - Family MedicineE. Gregory Thompson MD - Internal MedicineKathleen Romito MD - Family MedicineRobert B. Keller MD - Orthopedics
Current as of: March 2, 2020
Author: Healthwise Staff
Medical Review:William H. Blahd Jr. MD, FACEP - Emergency Medicine & Donald Sproule MDCM, CCFP - Family Medicine & Adam Husney MD - Family Medicine & E. Gregory Thompson MD - Internal Medicine & Kathleen Romito MD - Family Medicine & Robert B. Keller MD - Orthopedics
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