What is spondylolisthesis?
Spondylolisthesis is a spine condition where one of the bones in your back, known as a vertebra, slips out of its normal position and moves forward over the bone below it. This slippage can put pressure on nearby nerves, leading to discomfort, numbness or weakness, especially in your lower back and legs. It can also cause a sense of instability, or a “catch”, when standing up from a seated or lying position.
Spondylolisthesis can affect people of all ages, but it's most common in adults due to wear and tear on the spine over time. It can happen in younger athletes who participate in sports that put repeated stress on the lower back, such as gymnastics, football or weightlifting.
There are several types of spondylolisthesis, with the two most common being:
- Degenerative spondylolisthesis: This type occurs as part of the natural aging process. Over time, the discs and joints in your spine can wear down, making it easier for a vertebra to slip out of place.
- Isthmic spondylolisthesis: This type develops from a small stress fracture in a part of the vertebra called the pars interarticularis. This tiny crack can weaken the bone’s stability, putting more stress on the disc, which causes it to wear out, allowing the vertebrae to slip forward.
Other, less common forms of spondylolisthesis may be present at birth, result from traumatic injuries, or occur as complications from other spinal conditions.
Anatomy of the spine
Your spine is made up of small bones called vertebrae, which are stacked on top of each other like building blocks. These bones help support your body, protect your spinal cord, and allow you to move and bend.
Between each vertebra are spongy discs that act like shock absorbers, helping your spine move comfortably. Small joints, strong muscles and ligaments also work together to keep your spine stable and aligned.
Spondylolisthesis happens when one of these bones slips out of its normal place and moves forward over the bone below it. This can happen for a few reasons, like:
- A small crack or stress fracture in part of the vertebra (called the pars interarticularis)
- Natural wear and tear on the spine as we age
When a vertebra slips out of place, it can put pressure on nearby nerves, causing back pain, leg pain and other symptoms associated with spondylolisthesis. Often, these symptoms worsen with prolonged walking or standing and when transitioning to standing.
Spondylolisthesis symptoms
Many people with spondylolisthesis don’t experience any noticeable symptoms. However, when symptoms do occur, the most common one is lower back pain. This pain may:
- Feel like a pulled or strained muscle
- Spread to the buttocks or the back of the thighs
- Get worse with activity and improve with rest
Some people with spondylolisthesis may also have muscle spasms, which can cause:
- Stiffness in the lower back
- Tightness in the muscles at the back of the thighs (hamstrings)
- Difficulty standing or walking for long periods
In more serious cases, when the slipped bone presses on nearby nerves, you might feel tingling or numbness (sciatica) in one or both legs, or experience weakness in your legs.
When to see a doctor
Make an appointment with a spine specialist if you have pain in your lower back, thighs or buttocks, or tingling down your leg that doesn’t improve after three to four weeks. Seek medical help if you have weakness, trouble walking or standing up straight.
What causes spondylolisthesis?
Spondylolisthesis can happen in children, often due to a birth defect or a sudden injury. It most commonly affects the area where the lower back connects with the pelvis.
In adults, spondylolisthesis is usually caused by wear and tear on the spine over time. This can happen due to conditions like arthritis, injuries from accidents or issues like fractures, tumors or abnormal bone growth.
Sports that put a lot of stress on the bones, such as football or gymnastics, can also lead to problems with the spine. Over time, these activities may cause additional damage, weakening the bones and making it more likely for the vertebrae to slip out of place.
Spondylolisthesis risk factors
Several factors can increase your risk of developing spondylolisthesis, including:
- Age: The spine naturally weakens and degenerates with age, especially after 50.
- Sex: Women, particularly after menopause, are more prone to spondylolisthesis.
- Family history: A family history of spine issues or congenital spine abnormalities can increase your risk.
- Repetitive activity: Athletes in sports like gymnastics, football or weightlifting that involve repetitive strain on the back are at higher risk.
- Spinal abnormalities: Birth defects like spina bifida can make the spine more vulnerable.
- Traumatic injury: Accidents or falls that cause stress fractures in the spine can lead to spondylolisthesis.
- Excessive weight or poor posture: Extra weight or poor posture puts added stress on the spine, increasing the risk of injury.
- Other conditions: Conditions like rheumatoid arthritis weaken joints, making the spine more prone to slippage.
Being aware of these risk factors can help you take steps to prevent or manage spondylolisthesis, especially if you have multiple risk factors. Regular exercise, maintaining a healthy weight and practicing good posture are all important ways to protect your spine.
Diagnosing spondylolisthesis
Your provider can diagnose spondylolisthesis with a physical exam and imaging tests. Spondylolisthesis symptoms can mirror those of other back and spine conditions, so your provider will want to make sure the diagnosis is accurate before recommending treatment.
Spondylolisthesis treatment
Treatment options vary based on the severity of spondylolisthesis. Many people can still live active lives with this condition. For most people, performing exercises that strengthen the lower back muscles and avoiding activities that could overextend the back help to improve symptoms.
In more severe cases, surgery might be necessary to stabilize the spine and relieve pressure on nerve roots. Usually, surgery becomes an option after other treatment methods no longer help with your symptoms.
Find specialized spondylolisthesis care near you
If you're experiencing back pain, numbness or other symptoms of spondylolisthesis, take the next step toward relief with expert care at Baylor Scott & White. With convenient locations across North and Central Texas, our orthopedic and neuro spine specialists are ready to diagnose your condition and create a personalized treatment plan. Get the care you need to feel better and get back to what you love.
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