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.
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.
