Spondylolisthesis is a condition that occurs when a bone in the lower spine shifts out of position and is displaced forward over the bone beneath it. The condition may develop from spondylolysis, which is a stress fracture in one of the bones (called vertebrae) that make up the spinal column. Spondylolisthesis occurs when spondylolysis weakens the bone so much that it starts shifting out of position in the spinal column. Spondylolisthesis can also be a result of arthritis when the facet joints become worn out and are no longer able to stabilize the vertebra (degenerative spondylolisthesis). If the bone shifts out of position too much, it may begin to press on nerves. Compression of nerves may cause shooting pain down the legs.
Spondylolisthesis can have a variety of symptoms. Some people may not experience any symptoms at all. For others, symptoms can be mild to severe and include low back pain, tightness in the hamstring muscle, stiffness, tenderness surrounding the area of the slipped disc, and pain shooting down the thighs and buttocks. Spondylolisthesis may cause kyphosis. Many patients may develop symptoms from compression of the nerves.
Spondylolisthesis can affect both children and adults. There are three common forms of spondylolisthesis:
Three less common forms of spondylolisthesis include:
In children, the condition most commonly affects the fifth bone in the lower spine and the first bone in the pelvic area. When spondylolisthesis is present in children, it is usually caused by a birth defect (congenital spondylolisthesis) or a repetitive injury or stress fracture (isthmic spondylolisthesis). In sports that place significant stress on the lower back, such as gymnastics, football and weightlifting, those bones are susceptible to stress fractures on one or both sides of the vertebra. In adults, the condition is most often caused by arthritis (degenerative spondylolisthesis).
Treatments for spondylolisthesis vary depending on the patient and severity of the condition. Dr. Amin usually first recommends non-surgical treatments such as stretching, modifying activity, avoiding sports, taking anti-inflammatory medications to reduce pain, and a trial of physical therapy.
If a patient’s symptoms do not improve following conservative treatment, then Dr. Amin may recommend surgery for spondylolisthesis. The goal of the surgery is to relieve pain, stabilize the spinal bones that have slipped out of position, and improve the patient’s functionality. Dr. Amin may recommend one of these surgeries: