What is Spondylolisthesis?

Daily life can take its toll on our spine. This becomes especially noticeable as we age and the skeletal components that reinforce our spine degrade. Spondylolisthesis, a common complication of spinal degeneration, occurs when an unprotected vertebra slips painfully forward over the vertebra that lies beneath it.

Degenerative Disc Disease is a common cause of spondylolisthesis. As we age, our intervertebral discs—the rubbery cushions that protect our spinal vertebrae from vertical or horizontal forces known as compression and shear—become dryer. Loss of this natural defense significantly increases our likelihood of sustaining an accidental injury, such as a slipped vertebra (spondylolisthesis) or a ruptured disc.

The aging process can also weaken the hinge-like facet joints that support our spinal vertebrae on the backside of our spine. Breakdown of these joints promotes excess forward flexion of the spine, advancing the progression of arthritis and leaving our spine defenseless against spondylolisthesis. We normally think of spinal flexibility as a good thing; however, an unaligned vertebra can impinge upon neighboring nerves, resulting in symptoms of excruciating discomfort and muscular weakness.

What are the Symptoms of Spondylolisthesis?

General Symptoms:

Although spondylolisthesis can occur at any level of the spine, it is most common in the weight-bearing region of the lower back (the lumbar spine). Since spondylolisthesis often involves the degradation of more than one skeletal component, the symptoms can range from virtually absent to debilitating. Common symptoms may include:

  • Localized pain in the lower back at the site of vertebral slippage
  • Sciatica, or warm, piercing pain that radiates from the sciatic nerve in the lumbar spine and down through the buttocks, posterior thigh, calves, and/or feet
  • Numbness or prickling in the upper or lower limbs
  • Increased tightness in the hamstrings or gradual weakening of the leg muscles
  • Pain that worsens while standing or with exertion
  • Development of swayback (or lordosis) that may interfere with your gait or render walking extremely painful
  • Emergency Symptoms: Seek immediate medical attention if your spondylolisthesis symptoms include: sudden, crippling pain, difficulty controlling your bowel or bladder, sensations of numbness in the saddle region of the buttocks or groin, or fever.

In addition, there are many different kinds of spondylolisthesis—not all of which are the result of aging. For example, the condition may be congenital (or present at birth) as in Dysplastic Spondylolisthesis; or, the disorder may result from a traumatic blow to the spine as in Traumatic Spondylolisthesis. However, the two most common types of spondylolisthesis are:

Degenerative Spondylolisthesis

This type of spondylolisthesis occurs when the skeletal and cartilaginous components that support our spinal vertebrae lose their capacity to maintain proper alignment of the spine. The process that leads to this form of spondylolisthesis is known as spinal degeneration and can result from a number of factors: Degenerative Disc Disease, Facet Joint Osteoarthritis, etc.

Isthmic Spondylolisthesis

This form of spondylolisthesis develops from a fracture in the pars interarticularis—a tiny sliver of bone that resides on the backside of the spine where the vertebrae that form the facet joints connect. This form of spondylolisthesis is most common in younger people, with athletes such as gymnasts, football players, and weightlifters being the most affected.

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What are the Treatments for Spondylolisthesis?

Non-Surgical Treatments:

Spondylolisthesis is a fairly common condition – so common in fact that some people never even realize that they have it! A slipped vertebra may go undetected until a neighboring nerve is irritated, shooting telltale signals of pain into the arms or legs. In mild to moderate cases of spondylolisthesis, the following non-surgical remedies are recommended:

  • Rest, immobilization, or heat and ice application to the injured area
  • Pain or anti-inflammatory medications to ease temporary discomfort
  • Physical therapy to enhance core strength, loosen up tight hamstring muscles, and increase range of motion in the lower back
  • Manual spinal manipulation or realignment from a licensed chiropractor
  • Steroidal injections to provide pain relief at the site of spondylolisthesis

Non-surgical treatment options can allow patients to continue about their lives with dramatically reduced pain. However, when non-operative treatments fail to produce satisfactory results, our board certified surgeon, Dr. Frazier, has acquired over 20 years of surgical expertise with minimally invasive spondylolisthesis treatments. Dr. Frazier may recommend:

Lumbar Laminectomy

A lumbar laminectomy is an outpatient decompression procedure, in which your surgeon removes a tiny segment of the lamina—the backside portion of a degenerated vertebra. Extraction of the lamina allows for the decompression of pinched nerves. This procedure may be combined with a spinal fusion to reinforce the structural integrity of the lumbar spine.


A TLIF (Transforaminal Lumbar Discectomy with Interbody Fusion) is a minimally invasive surgical solution, in which your surgeon performs the entire procedure through a tiny tube that allows for access to the spine. During this procedure, your surgeon removes the problematic intervertebral disc and uses a bone graft to fuse together the remaining gap.

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