Spondylolisthesis
Understand the Risks of Spondylolisthesis
If you’ve ever experienced back pain that radiates down your legs or lower back, then you may be suffering from spondylolisthesis. This is a condition where one of your lower spinal vertebrae slips out of place and over another one.
Do you want to know more about the diagnosis and treatment options to manage the pain associated with this condition? In this article, you can learn all you need to know about spondylolisthesis, from the symptoms and causes to the treatments available to help relieve your discomfort. We will provide an overview of the condition as well as tips for managing your symptoms. With this information, you can better understand spondylolisthesis and make informed decisions about your care.
What is spondylolisthesis?
Spondylolisthesis is the forward slippage (listhesis) of one vertebral body (spondylo) over the next lower vertebral body. There are a variety of causes and classification schemes, but most can be described as either degenerative (due to chronic inter-segmental instability involving degenerative disc and facet joints) or isthmic (due to developmental lesions involving the posterior arch of the vertebra).
Degenerative spondylolisthesis usually affects older patients, more frequently involves women and the L4/5 level, and has relatively small slips (30%) with associated stenosis. In contrast, isthmic spondylolisthesis usually affects patients younger than 50, primarily involves the L5 level, and may have quite severe progression and associated structural abnormalities.
Introduction
Spondylolisthesis is a forward slippage (listhesis) of one vertebral body (spondylo) over the next lower vertebral body. There are a variety of causes and classification schemes but most can be described as either degenerative (due to chronic inter-segmental instability involving degenerative disc and facet joints) or isthmic (due to developmental lesions involving the posterior arch of the vertebra).
Degenerative spondylolisthesis usually affect older patients, more frequently involve women and the L4/5 level, and have relatively small slips (<30%) with associated stenosis. In contrast, isthmic spondylolisthesis usually affect patients younger than 50, primarily involves the L5 level, and may have quite severe progression and associated structural abnormalities.

Figure 1: Illustration demonstrating the pathology of both degenerative and isthmic spondylolisthesis
Prevalence of spondylolisthesis
The prevalence of spondylolisthesis is on the rise as doctors diagnose it more frequently, and it is estimated that 6–7% of individuals under the age of 18 suffer from isthmic spondylolisthesis. Grade I spondylolisthesis is the most common type of the disorder, accounting for 75% of reported cases.
Among adults, a separate study shows that the prevalence of spondylolisthesis is highest for those in the middle-aged groups, with 13.10% of 50-54-year-olds, 14.85% of 55-59-year-olds, and 22.82% of 60-64-year-olds suffering from it. Males were more affected in all three groups, at 13.55%, 14.77%, and 18.76%, respectively, while female rates were 12.53%, 14.93%, and 28.57%.
It appears that the prevalence of spondylolisthesis is on the rise, and it’s important that we take steps to reduce the risk. Taking care of our spines, maintaining strong core muscles, and seeking out the help of a physical therapist when needed can go a long way toward managing and treating spondylolisthesis.
What are the symptoms of spondylolisthesis?

Spondylolisthesis is a medical condition in which one of the vertebrae slips out of place and onto the vertebra below it. It typically occurs in the lumbar spine, although it can also affect the cervical spine. If left untreated, spondylolisthesis can cause severe pain and disability, so it’s important to be aware of its symptoms.
The most common sign of spondylolisthesis include:
- Low back pain: The most common symptom of spondylolisthesis is low back pain that usually spreads to the buttocks and the thighs.
- Muscle weakness: People diagnosed with spondylolisthesis can experience muscle weakness in their legs, making it harder to walk or stand.
- Leg numbness: Numbness or tingling in one or both of the legs can be caused by spondylolisthesis which can put pressure on the nerve pathways.
- Stiffness in the spine: Stiffness in the spine or lower back can be felt due to spondylolisthesis.
- Difficulty standing upright: Difficulty or pain when transitioning from standing to sitting position or vice versa can be caused by inflamed tissue or the vertebrae shifting when transitioning from one position to another.
- Stooped posture: People with spondylolisthesis may find it difficult to stand or sit upright and can start to hunch their shoulders or have a stooped posture.
- Difficulty walking: People may experience difficulty walking as a result of spondylolisthesis. Pain may increase when walking or running on uneven surfaces or on an incline.
- Bowel and bladder dysfunction: Pressure on the nerve pathways can lead to bowel and bladder dysfunction, which includes the inability to control one’s passing of urine and stools.
How do I diagnose spondylolisthesis?
If you are experiencing lower back pain, you may be suffering from a condition known as spondylolisthesis. This is the slippage of one vertebra over another, usually in the lower back area. Diagnosing spondylolisthesis can be completed through physical exams or imaging techniques. Here’s an overview of how to diagnose it:
- Physical exam
During the physical exam, the doctor will apply pressure to the spine and check for the presence of pain, joint noise when the lower back is moved, and abnormal curvature of the spine. In some cases, she may use a special back examiner to evaluate your range of motion and neurologic symptoms.
- Imaging
Imaging tests are used to take detailed pictures of the spine. X-rays, MRIs, or CT scans can demonstrate the degree of vertebral displacement or any other damage to the spine.
- Electrodiagnostic testing
This test uses electrodes to monitor the electrical activity in your spine and muscles. It can help pinpoint any muscle problems or nerve disturbances that could be associated with your pain.
It’s important to note that the only way to officially diagnose spondylolisthesis is through imaging tests combined with a physical exam. However, if you’re still experiencing pain despite trying various treatments, it’s important to make an appointment to get checked out by a doctor. Diagnosing spondylolisthesis is key to getting the right treatment and reducing your risk of pain and disability.
What are the treatments for spondylolisthesis?
Spondylolisthesis is a common spinal alignment disorder in which one vertebra slips over another due to a defect or fracture in the vertebra’s facet joint. Depending on the severity of the condition, it can cause severe pain, numbness, and tingling in the legs, as well as other issues. Fortunately, there are several treatments available for spondylolisthesis.
- Physical therapy
Physical therapy targets the muscles surrounding the spine, helping them to become stronger and more flexible. This can help alleviate pain and reduce symptoms of spondylolisthesis. Physical therapy may also help improve posture.
- Bracing
Braces are designed to limit movement and provide support for the affected area. This can help relieve pain and improve spinal alignment. Bracing can also be used in conjunction with physical therapy and rest.
- Lifestyle changes
Finally, lifestyle changes may be recommended for spondylolisthesis. Regular exercise and stretching can help strengthen the muscles and improve spinal alignment. It is also important to maintain a healthy weight and avoid activities that put additional strain on the spine.
- Medication
In some cases, medications may be prescribed to help with the symptoms of spondylolisthesis. Pain medications like ibuprofen or acetaminophen can help reduce the pain and inflammation associated with the condition. Steroids can also be used to reduce inflammation and swelling.
If you are experiencing symptoms of spondylolisthesis, it’s important to speak with a doctor to discuss which treatment option is best for you. With the right combination of treatments, you can significantly reduce your symptoms and improve your quality of life.

What are the risk factors for spondylolisthesis?
While this condition can occur in any part of the spine, it’s most commonly seen in the lower back, or lumbar spine. Knowing the risk factors for spondylolisthesis can help you recognize any warning signs and get treated early. The risk factors for spondylolisthesis can be divided into two categories:
- Age
Age is the strongest risk factor. Spondylolisthesis is more common in people over 50 because the spine naturally weakens as it ages. It’s also more common in adolescents and young adults as a result of growth.
- Lifestyle
Lifestyle habits can also play a role. For instance, athletes who participate in high-impact sports, such as football, weightlifting, and gymnastics, are more at risk. This is because constant and repetitive stress placed on the spine can lead to tension and strain that weaken the bones over time.
To help prevent the development of spondylolisthesis, it’s important to keep your spine healthy and strong. This involves activities like stretching and strengthening exercises, monitoring your posture, and taking breaks from high-impact activities. If any of the risk factors apply to you, it’s important to talk to your doctor about prevention and early treatment.
Get medical help today with Dr. Matthew Hepler MD!
Having spondylolisthesis can be a serious problem that can lead to severe pain and discomfort. If left untreated, it can worsen over time. Getting medical help is essential in order to properly manage and treat this condition. Dr. M. Hepler is one of the best spine surgeons in South Florida, and his practice is the perfect place to receive spondylolisthesis medical care.
If you experience pain that radiates down your legs, it is important to seek medical help. Your doctor can diagnose the cause of your pain and provide treatment to help relieve it. With Dr. Matthew Helpler, you can rest assured that you are in good hands.
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The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions or concerns you may have regarding your health.