Spondylolisthesis

Most low back pain gets better without treatment, but some conditions that cause recurrent back pain may require medical or surgical care. A herniated disc is one such condition that many people are familiar with, but there are many others, including spondylolisthesis. It is important to get the correct diagnosis for any spine problem.

What is spondylolisthesis?

Spondylolisthesis is a condition where spinal vertebrae slips over one another. Forward slippage (anterolisthesis) is far more common than backward slippage (retrolisthesis).

What is spondylolysis vs. spondylolisthesis?

These are separate but sometimes related conditions with similar sounding names. Spondylolysis is a particular type of spine fracture that, in some cases, can lead to spondylolisthesis, in which there is an incorrect movement and positioning (usually forward) of one or more spine vertebrae.

Spondylolisthesis animation

What causes spondylolisthesis?

Spondylolisthesis occurs most commonly in older adults as a result of osteoarthritis of the spine. This is known as degenerative spondylolisthesis. But there are several other types of spondylolisthesis, each having a distinct underlying cause.

Types of spondylolisthesis

• Degenerative spondylolisthesis, as noted above, is caused by spinal osteoarthritis, also known as spondylosis, in which facet joints and discs of the spine deteriorate over time. This is the most common form on spondylolisthesis
• Isthmic spondylolisthesis is caused by a pars interarticularis defect, also known as a pars fracture or spondylolysis. The crack of a pars fracture affecting both sides of the connection between the lamina and pedicles leads to slippage of the vertebrae.
• Congenital or dysplastic spondylolisthesis is a birth defect in which there is a growth abnormality of the spine.
• Traumatic spondylolisthesis is where a trauma to the spine forces vertebrae out of alignment.
• Pathologic spondylolisthesis is caused by a separate bone disease, such as a spinal tumor or osteoporosis.
• Iatrogenic (postsurgical) spondylolisthesis is caused by spinal destabilization resulting from a prior spinal decompression surgery without instrumentation.

What are the symptoms of spondylolisthesis?

Symptoms of spondylolisthesis can include localized lower back pain and/or – if there is associated nerve compression – pain and/or numbness (neuropathy) that radiates down to the legs.

Is spondylolisthesis serious?

Spondylolisthesis is generally not a serious or dangerous condition. Most patients with spondylolisthesis have few or no symptoms. Spondylolisthesis only becomes a concern when patients develop associated symptoms due to nerve compression (radiculopathy), disc degeneration or osteoarthritis. 

How is spondylolisthesis treated?

Treatments vary by individual case. Nonsurgical treatments may include activity reduction, a back brace, physical therapy and/or corticosteroid injections. In severe cases, spine surgery may be required to alleviate chronic pain or nerve damage.

What happens if spondylolisthesis is left untreated?

Most cases of spondylolisthesis do not cause any symptoms. If patients have limited or no symptoms, it is typically not dangerous to leave spondylolisthesis untreated.

What is the surgery for spondylolisthesis?

Operative treatments may involve some type of spinal decompression surgery, spinal fusion surgery (primarily an ALIF, PLIF, or TLIF surgery), or both. Learn more from the content below, or find an HSS physician or orthopedic surgeon who treats spondylolisthesis.

Updated: 3/9/2023

Reviewed and updated by Sravisht Iyer, MD