Spondylolisthesis

In spondylolisthesis, one of your spinal bones (vertebrae) slides forward over the bone below it. It’s most common in the lumbar spine (lower back) but can also occur in the cervical spine (neck). The sliding bone can press on the spinal  cord or nerves, causing pain, weakness and other symptoms. Timely treatment is important because spondylolisthesis can worsen over time.

Causes

Spondylolisthesis is caused by changes in the spine’s facet joints. These small joints are linked, keeping the vertebrae aligned while allowing the spine to move. The spinal discs help cushion the joints.

With age, the discs can flatten, allowing the facet joints to break down or slide out of place. When the vertebrae move forward slightly, this is called degenerative spondylolisthesis or pseudo-spondylolisthesis.

Bone defects can also cause spondylolisthesis. The bones that connect the facet joints are prone to stress fractures in some people, letting the vertebrae slip out of place.

Symptoms

Symptoms can come on suddenly. They tend to get better with rest, though they might not go away completely.

  • Low-back or neck pain
  • Pain that radiates down the arms or legs
  • Pain that gets worse with exercise
  • Hamstring (back thigh) tightness
  • Neck stiffness
  • Loss of spine flexibility
  • Pain, numbness, tingling or weakness in the arms, hands, legs or feet
  • Muscle spasms in the back or neck

Nonsurgical treatments

The OHSU Spine Center favors noninvasive treatments for spondylolisthesis whenever possible.

  • Rest
  • Physical therapy: Exercises to strengthen your neck, trunk and abdominal muscles and to increase spine flexibility can help.
  • Bracing: Wearing a brace can help if you have muscle spasms.
  • Medication: Nonsteroidal anti-inflammatory medication can help.

Surgical treatment

Surgery may be recommended if you have severe symptoms, if the vertebrae have slid far out of place, or if other treatments didn’t help.

  • Spinal fusion surgery: This surgery permanently joins two or more bones (vertebrae) and is used in spondylolistheses to keep bones from moving.