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Conditions

Spondylolisthesis

A condition in which one vertebra slips forward over the vertebra below it, which can pinch nerves.

What is spondylolisthesis?

The vertebrae are normally stacked neatly on top of each other. In spondylolisthesis, one vertebra slides forward over the one below. This is most common in the lower back. The slip can be caused by:

  • Arthritis and disc wear (degenerative spondylolisthesis — the most common type in adults)
  • A small stress fracture in the back of the vertebra (isthmic spondylolisthesis)
  • An injury
  • A birth difference in the shape of the spine

Common symptoms

  • Low back pain, often worse with standing or bending backward
  • Pain, numbness, or tingling in the buttocks and legs
  • Tight hamstrings
  • Difficulty walking long distances
  • A feeling that the back is unstable or "catches"

Some people have a slip on their X-ray but feel fine. Symptoms depend on how much the slip is pinching the nerves and how unstable the segment is.

Treatment options

Nonsurgical

  • Physical therapy focused on core strength and posture
  • Medications
  • Activity adjustments
  • Spinal injections

Surgical

When nonsurgical care does not relieve symptoms, surgery may be considered. Because the spine has slipped and is often unstable, surgery usually combines a decompression (taking pressure off the nerves) with a spinal fusion (locking the slipped level together to stop the motion).