Spondylolisthesis: A comprehensive overview
Discover spondylolisthesis, its types, symptoms, causes and risk factors. Get information about diagnosis of spondylolisthesis, treatment options and how to manage life with it.
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Last updated on 3rd Jul, 2025
What is Spondylolisthesis?
Spondylolisthesis is a disorder that is caused when one of the bones in the spine slips out of place and presses down on the vertebra below it. The slipped bone exerts pressure on a nerve, which then produces pain in the lower back and legs. It can take place anywhere in the spine, however most commonly happens at the base of the spine. Spondylolisthesis usually responds very well to treatment.
What are the Types of Spondylolisthesis?
There are six main types of spondylolisthesis, such as:
Degenerative spondylolisthesis: The most common type of spondylolisthesis, it happens when the body naturally grows old and the disk that cushion vertebrae gets worn and thinner.
Isthmic Spondylolisthesis: This is caused by spondylosis, a condition in which the cartilage and bones of the neck abnormally wears. It is caused when the bone that connects two vertebrae together breaks. It also happens if an individual has thinner vertebrae developed since birth.
Congenital spondylolisthesis: This type is caused when the vertebrae are incorrectly aligned as a result of birth defect.
Traumatic Spondylolisthesis: In this type of spondylolisthesis, an injury or accident causes the vertebrae to move out of its usual spot.
Pathological spondylolisthesis: This type of spondylolisthesis is developed by another spine condition, like osteoporosis or a spinal tumor.
Postsurgical spondylolisthesis: This type is rare. It can be caused by a side effect of having spinal surgery.
Prevalence of Spondylolisthesis
Degenerative spondylolisthesis majorly happens to adults and is also more common in females than males. There is more risk in the obese to develop this disorder.
Isthmic spondylolisthesis is more common in the adolescent and young adult population however it may not be discovered until symptoms start developing in adulthood. The prevalence of isthmic spondylolisthesis in males is found to be higher.
Congenital spondylolisthesis is found to be more common in the paediatric population (birth to 18 years of age). Women are more commonly affected than men.
What are the Causes?
The causes of Spondylolisthesis vary person to person. Some are born with defective vertebrae while others may experience any injury to the back. The typical causes are as follows:
fractures caused by injury
joint injury caused by arthritis or any illness
degeneration from overuse or aging
defect in spine from birth
spondylolysis
tumors
surgery
What are the Risk factors?
The risk factors for spondylolisthesis may include having a first-degree relative with spondylolisthesis, scoliosis, or spina bifida. Other risk factors include a history of repetitive trauma or hyperextension of the lower back or lumbar spine. Athletes who play certain sports for example, gymnasts, weightlifters, and football players may be at greater risk for developing spondylolisthesis. People older than 50 years are also at risk of developing the disorder.
What are the symptoms of Spondylolisthesis?
The common symptoms are:
Back stiffness
Difficulty walking or standing for more than a few minutes at a time
Numbness, weakness or tingling in your feet
Pain in the lower back
Tight hamstrings
In some cases, people may have spondylolisthesis and never experience symptoms. The reason being very minor slippage may not put enough pressure on the rest of the spine or nerves to cause any symptoms.
Is it Spondylolisthesis or common back pain?
Here are some ways to differentiate spondylolisthesis from common back pain:
Location of pain: Spondylolisthesis pain is usually located in the lower back, while common back pain can occur anywhere in the back.
Type of pain: Spondylolisthesis pain is usually described as severe aching pain that gets worse with activity and better with rest. Common back pain can be sharp, stabbing, or throbbing.
Other symptoms: Spondylolisthesis can also cause stiffness in the back, muscle spasm and difficulty in walking. Common back pain may also cause muscle spasms, but it is less likely to cause stiffness or difficulty walking.
Diagnosis of Spondylolisthesis
Below are some of the procedures used by doctors to diagnose spondylolisthesis.
Medical history: The doctor may ask the individual about the medical history to help determine whether slipped vertebrae are causing the symptom. The doctor may also ask to describe when the pain first occurred, the location of the pain, whether it occurred immediately after an activity like lifting of heavy weight or the pain occurred gradually.
Physical Exam: The doctor may further perform physical examination to understand the cause of pain, by gently manipulating the legs in different extended positions to check if any movement is causing the pain.
Neurological Evaluation: This step helps doctors to determine whether any nerve damage is causing the symptoms. The doctor may also use a small hammer to test unresponsive nerve reflex in different parts of the body.
X-ray: This procedure can help to produce an image of vertebrae that has moved forward. X-ray provides more information about the severity of the slipped vertebra and the impact on surrounding bones.
CT Scan: CT Scan is needed when the doctor requires to picture the vertebrae more closely. CT Scan gives doctors more information about a possible fracture in the bones that help keep vertebrae in place.
MRI Scan: In case the symptoms indicate the chances of compressed nerve, doctors may opt for MRI to determine if slipped vertebrae has pressed the nerve or any swelling in the spinal bone.
Bone Scan: This helps doctors to decide whether a fractured vertebra is actively healing or is an old injury.
What is Grading of Spondylolisthesis?
The severity of Spondylolisthesis is based on grade to determine what sort of treatment one needs.
Grade 1: 1-25 percent slip
Grade 2: 26-50 percent slip
Grade 3: 51-75 percent slip
Grade 4: 76-100 percent slip
What is the treatment of Spondylolisthesis?
In most cases, non-surgical treatment such as physical therapy and bracing can relieve pain and improve the functioning. The following are some of the non-surgical treatments to treat spondylolisthesis.
Activity modification and bracing: When the pain is increased by any activity it is recommended taking a break until pain subsides. Doctors may also ask one to wear a back brace to support the lower back and prevent the spine from developing unusual curves.
Physical Therapy: Physical therapy can reduce lower back pain. Stretching the muscles that support the spine may also relieve discomfort and reduce stress on the lower back.
Pain Relief Medication: Doctors may prescribe over-the-counter nonsteroidal anti-inflammatory drugs, or NSAIDs to reduce inflammation in the spine and surrounding tissues. The most common NSAIDs are ibuprofen, naproxen, and aspirin.
Corticosteroid Injection: Corticosteroid injection provides anti-inflammatory medication directly to the spine. Mostly, injection is recommended only if the other non-surgical treatments do not provide relief.
In fewer cases, where individuals with spondylolisthesis do not respond to non-surgical treatments, surgery is required to relieve the pain and prevent the condition from advancing. The surgical treatments are:
Pars Repair: In this procedure, the fractured portion of the vertebrae is stabilized by using wires or screws to join the sides of the fractured bone and put the vertebrae in place. If the fractured bone is very weak and needs to be strengthened, tissue from other parts of the body is used to help the affected bone heal.
Spinal Decompression: In this method, the pressure on the nerves is relieved that alleviates pain and improves the functioning of the spine. There are three types of spinal decompression.
Laminectomy
Foraminotomy
Discectomy
Spinal Fusion
Lifestyle Modifications and Management
The below measures can be adopted to manage Spondylolisthesis:
Weight loss strategies, balanced diet and regular exercise routine
Low-impact exercise helps strengthen the back muscles that support the spine, promotes circulation and improves flexibility
Quitting cigarette smoking can improve the recovery from the surgery
What are the Prevention strategies?
One can lower the risk of Spondylolisthesis by following the below measures:
Practice physical activities that strengthen back and abdominal muscles.
Follow a good diet plan. This can help protect bone health.
Talking with a health-care provider about bone health.
It is important to note that one will not always be able to prevent this disorder because sudden injuries or the way the spine forms can cause spondylolisthesis.
Living with spondylolisthesis
Living with spondylolisthesis can be difficult but not impossible. The following measures can help one to live better with spondylolisthesis:
Avoid movements which make the condition worse.
Consult a specialist to understand what activities are safe.
Walking helps to keep the muscles and joints moving.
Sit with good posture. Do not slouch.
One may keep the back supported by using a pillow.
Sit with the fleet flat on the ground. Do not sit crossed-leg.
Avoid gymnastic, weightlifting, wrestling, etc. activities which require bending, twisting or flexing the spine.
Conclusion
Spondylolisthesis is a disorder that is caused when one of the bones in the spine slips out of place and presses down on the vertebra below it. There are around six main types of spondylolisthesis - Degenerative spondylolisthesis, Isthmic spondylolisthesis, Congenital spondylolisthesis, Traumatic Spondylolisthesis, Pathological spondylolisthesis and Postsurgical spondylolisthesis. Pain in the lower back, stiffness, difficulty in walking, numbness in the feet, pain to the bottom of thighs, etc. are some of the symptoms. It is important to diagnose spondylolisthesis at an early stage to treat it appropriately and prevent further complications. Treatment of this disorder includes both surgical and non-surgical procedures. However, in most cases spondylolisthesis can be treated with non-surgical procedures. Light exercise and a balanced diet can help to prevent it from developing.
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