Spondylolisthesis

Spondylolisthesis is a slipping of one vertebra on another. The slipping can result in narrowing around nerves in the spine called stenosis.  Spondylolisthesis can happen at any level of the spine, but usually occurs towards the bottom of the lumbar spine.

Spondylolisthesis is generally not dangerous. In many individuals, it is asymptomatic, however, in some it can become painful. The pain can be variable, but usually includes leg pain, buttock pain, and some back pain. Some individuals experience a heaviness or weakness in their legs that makes prolonged standing and/or walking difficult. Often these symptoms are relieved by sitting.

Spondylolisthesis is usually diagnosed with x-rays. Sometimes it is also seen on an MRI or a CT scan.

Treatment for spondylolisthesis ranges from self exercise to surgery. In most studies of spondylolisthesis, surgery is more effective than nonsurgical treatment. However, some individuals do achieve an acceptable level of function with nonsurgical care. Nonsurgical treatment usually includes a good exercise program which is often supervised by a physical therapist. The program is gradually transitioned into a self exercise program. Some people achieve enough relief from the exercise program that no further treatment is needed. In addition to therapy, many individuals take advantage of chiropractic therapy for painful flare-ups.

If exercise does not provide satisfactory relief, epidural injections often give temporary relief of pain. These are generally done by rehab medicine or pain management physicians.

Surgery has been shown to provide the most significant relief of buttock and leg symptoms from spondylolisthesis. It also tends to relieve some of the sharp, unpredictable low back pain. Unfortunately, surgery does not relieve all back pain, and most individuals are left with some dull, achy back pain which generally responds well to exercise over time.