Spondylolisthesis

Spondylolisthesis means the slipping of one vertebra over the top of the one below it. The vertebrae are the box-shaped bones that make up the spine.

What is going on in the body?

Normally, the vertebrae are stacked up and aligned with each other. Under certain circumstances, one vertebra may slip forward over the one below. This usually occurs in the lower back area, though the neck can also be affected.

What are the causes and risks of the condition?

Inborn defects, injury, or diseases may cause this condition. In adolescents, the most common cause is spondylolysis. In this condition, the bony arch of the vertebra of the low back is abnormally soft and able to slip easily. In the elderly, the most common cause is osteoarthritis in the spine. In this condition, the joints between the vertebrae become worn and unstable.

The following activities increase a person's risk for spondylolisthesis:

What are the signs and symptoms of the condition?

A person with spondylolisthesis often has no symptoms. Those with symptoms may complain of low back pain that is worst when the person is standing, weight-bearing, or playing sports. The pain may spread into the buttocks or thighs.

How is the condition diagnosed?

Diagnosis of spondylolisthesis begins with a history and physical exam. Because there are often no symptoms, this condition is often noticed by accident on X-rays of the lower back.

What can be done to prevent the condition?

Sports safety guidelines should be followed for adults, adolescents, and children.

What are the long-term effects of the condition?

In mild cases, the person may develop back pain during heavy lifting or sports. In more severe cases, the person may experience greater slipping of the spine and lower back discomfort. Problems with the nerves in the legs may possibly develop. The individual may lose bowel or bladder control.

What are the risks to others?

Spondylolisthesis is not contagious, and poses no risk to others.

What are the treatments for the condition?

Treatment depends on the age of the person, the degree of slip, and the cause. Treatment options for mild cases include:

An operation to fuse the affected vertebrae, called spinal fusion, is considered in serious cases. When the slip is great and there are symptoms of nerve involvement, surgery is often advised.

What are the side effects of the treatments?

Surgery may cause bleeding, infection, or allergic reaction to anesthesia. It can also cause nerve damage.

What happens after treatment for the condition?

The vertebrae may continue to slip despite appropriate treatment.

How is the condition monitored?

X-ray tests may be taken every 6 months during adolescence when the body is growing rapidly. Any new or worsening symptoms should be reported to the healthcare provider.

Author:John A.K. Davies, MD
Date Written:
Editor:Crist, Gayle P., MS, BA
Edit Date:08/10/01
Reviewer:William M. Boggs, MD
Date Reviewed:08/13/01