Spondylolisthesis

Reviewed on 9/13/2021

Spondylolisthesis Facts

Low back pain
Spondylosis can occur in the cervical spine (neck), thoracic spine (upper and mid-back), or lumbar spine (low back). Lumbar spondylosis and cervical spondylosis are the most common.

  • Slippage of one spinal vertebra over another is spondylolisthesis.
  • Spondylolisthesis occurs in different grades and can be either congenital or acquired.
  • Spondylolisthesis can cause symptoms by irritation of nervous tissue, either within the nearby spinal cord or of the adjacent spinal nerves.
  • Radiology imaging is used to confirm the diagnosis of spondylolisthesis.
  • Treatments of spondylolisthesis depend on the severity and persistence of symptoms.

What Is Spondylolisthesis?

Spondylolisthesis is slippage of one spinal vertebra over another. This most commonly occurs in the lower back in the lumbar spine.

What Are the Types of Spondylolisthesis?

Spondylolisthesis occurs in different degrees based on the amount of slippage of one vertebra on another. These degrees of slippage are medically termed grades. Accordingly, grade I is 0%-25%, grade II is 25%-50%, grade III is 50%-75%, grade IV is 75%-100%, and grade V is >100%.  See the below table.

Types of Spondylolisthesis
Grades Degrees of Slippage
grade I 0%-25%
grade II 25%-50%
Grade III 50%-75%
Grade IV 75%-100%
Grade V >100%

Spondylolisthesis can also be classified as congenital (present at birth) as a result of inherited factors or acquired as a result of injury or degeneration.

What Causes Spondylolisthesis?

In children, spondylolisthesis is often related to a defect in, or injury to, a portion of the lumbar vertebra that connects to the spinous process (called the pars interarticularis). Medical professionals refer to the "disconnection" of this bone (pars defect) as spondylolysis and leads to slippage of the entire body of the vertebra, or spondylolisthesis.

In adults, spondylolysis can be degenerative and lead to spondylolisthesis. Degeneration of the cervical or lumbar disc can cause spondylolisthesis in adults. This, too, can lead to spondylolisthesis of the vertebrae above and below the worn out disc.

What Are Spondylolisthesis Symptoms and Signs?

Spondylolisthesis commonly causes no symptoms or signs. When spondylolisthesis causes symptoms, they are typically a result of irritation of nervous tissue, either within the nearby spinal cord or of the adjacent spinal nerves. Such symptoms include low back pain, as well as pain, numbness, tingling, and weakness of one or both lower extremities. This can lead to leg pain, difficulty walking, incontinence, insomnia, and inability to function. Spondylolisthesis can lead to spinal stenosis with pain in the extremities with movement.

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How Do Doctors Diagnose and Grade Spondylolisthesis?

Spondylolisthesis is diagnosed by the history of chronic pain, numbness, tingling, and weakness of the extremities. Physicians confirm and visualize it with X-ray imaging. Health care professionals can also visualize it with CAT scan or MRI scan imaging.

What Are Treatments and Home Remedies for Spondylolisthesis?

Treatments of spondylolisthesis depend on the severity and persistence of symptoms. These include heat, analgesics, physical therapy exercises, braces, cortisone (steroid) injections, and orthopedic surgery procedures.

Home remedies include heat and/or ice applications, rest, avoiding reinjury, lumbar exercises, and acetaminophen (Tylenol), ibuprofen (Motrin, Advil), or naproxen (Aleve).

What Is the Prognosis for Spondylolisthesis?

The prognosis for spondylolisthesis depends on the cause, severity, and overall condition of the patient involved. Most spondylolisthesis can respond to conservative treatments. Patients with persisting symptoms, or with severe traumatic spondylolisthesis, may require surgery.

Is It Possible to Prevent Spondylolisthesis?

The only prevention for spondylolisthesis is to prevent spinal injury.

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Reviewed on 9/13/2021
References
Firestein, Gary S., et al. Kelley & Firestein's Textbook of Rheumatology, 2-Volume Set, 10th Edition. China: Elsevier, 2017.

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