Spondylolisthesis means that a bone of the lower part of the spine (a vertebra) has slipped out of position and onto the bone below it.
This is not to be confused with a slipped disc, where one of the spinal discs in between the vertebrae has ruptured.
What are the symptoms?
Spondylolisthesis may vary from mild to severe and there are not always symptoms.
But typically, people with spondylolisthesis experience:
- lower back pain, which is often worse with activity and may lead to sciatica (pain radiating down the legs as a result of nerve damage)
- tight hamstring muscles
- pain in the thighs and buttocks
- tenderness in the area of the slipped vertebra
Causes of spondylolisthesis
In children, spondylolisthesis is usually due to a birth defect in that area of the spine, or the result of a sudden injury.
In adults, it is most commonly caused by age-related wear of the spine or a degenerative disease such as arthritis.
Other possible causes in adults are:
- a bone disease
- a fracture as a result of a sudden injury
- a stress (hairline) fracture as a result of sustained pressure on the spine - commonly seen in gymnasts and weight lifters
When to see your doctor
You should see your doctor if:
- you have persistent back pain or stiffness
- you have persistent pain in your buttocks or thighs
- your back curves excessively
Your doctor will physically examine you and may ask you to do a straight leg raise, which is often painful if you have spondylolisthesis.
An X-ray of your spine (taken when you are standing) will show if one of your bones is out of place, and whether you have a fracture.
Treatment and outlook
Treatment varies depending on the severity of your condition. You may get better simply by doing some strengthening and stretching exercises and avoiding contact sports and over-stretching the spine.
You should try non-surgical treatments first, such as:
These measures will only provide temporary relief, but you may find symptoms go away with time anyway.
A back brace is not usually recommended as it doesn't let you use your core spinal muscles, and so weakens your spine.
You should avoid activities while you are still experiencing symptoms.
Uncorrected spondylolisthesis may sometimes result in kyphosis, where the top of the back is excessively curved and appears more rounded than normal.
Severe pain that does not get better may require surgery. This involves fusing the slipped vertebra to the neighbouring vertebrae.
Surgery carries a risk of nerve injury, so you should talk to your doctor about the pros and cons of this treatment and think about it carefully before you proceed.
The procedure is usually effective in relieving symptoms of severe spondylolisthesis when the vertebra is pressing on nerves.