Spondylolisthesis

Spondylolisthesis

Spondylolisthesis is a condition in which one of the bones of the spine (vertebrae) slips out of place onto the vertebra below it. If it slips too much, the bone might press on a nerve, causing pain. Usually, the bones of the lower back are affected.

The word spondylolisthesis comes from the Greek words spondylos, which means "spine" or "vertebra," and listhesis, which means "to slip or slide."

Types of spondylolisthesis

There are different types of spondylolisthesis. The more common types include.

Less common forms of spondylolisthesis include:

How common is spondylolisthesis?

Spondylolisthesis is the most common cause of back pain in teens. Symptoms of spondylolisthesis often begin during the teen-age growth spurt. Degenerative spondylolisthesis occurs most often after age 40.

What are the symptoms of spondylolisthesis?

Many people with spondylolisthesis have no symptoms and don't even know they have the condition. When symptoms do occur, low back pain is the most common. The pain usually spreads across the lower back, and might feel like a muscle strain.

Spondylolisthesis can also cause muscle spasms in the hamstring muscles in the back of the thighs. Tight hamstrings can cause the person to walk with short strides and with the knees slightly bent. If the slipped vertebra is pressing on a nerve, pain might spread down the leg to the foot. The foot might also tingle and/or feel numb.

How is spondylolisthesis graded?

A radiologist determines the degree of slippage upon reviewing spinal X-rays. Slippage is graded I through IV:

Generally, Grade I and Grade II slips do not require surgical treatment and are treated medically. Grade III and Grade IV slips might require surgery if persistent, painful, slips are present.

How is spondylolisthesis diagnosed?

An X-ray of the lower back can show a vertebra out of place. A computed tomography (CT) or magnetic resonance imaging (MRI) scan which produce more detailed images might be needed to more clearly see the bones and nerves involved.

How is spondylolisthesis treated?

Treatment for spondylolisthesis depends on several factors, including the age and overall health of the person, the extent of the slip, and the severity of the symptoms. Treatment most often is conservative, involving rest, medication, and exercise. More severe spondylolisthesis might require surgery.

What complications are associated with spondylolisthesis?

Persistent pain associated with spondylolisthesis can lead to reduced mobility and inactivity. Inactivity can, in turn, result in weight gain, loss of bone density, and loss of muscle strength and flexibility in other areas of the body. There is also a risk of permanent nerve damage if a slipped vertebra is pressing on a spinal nerve root.

What is the outlook for people with spondylolisthesis?

The chance of having a recurrence of pain depends on the severity of the spondylolisthesis. In the case of a minor slip, where the bone is not pressing on any nerves, the person might never have a recurrence of back pain related to spondylolisthesis.

In general, conservative treatment for mild cases of spondylolisthesis is successful in about 80 percent of cases. Surgery is successful in relieving symptoms in 85 percent to 90 percent of people with severe spondylolisthesis.

Can spondylolisthesis be prevented?

Although spondylolisthesis might not be preventable, there are steps you can take to reduce the risk of slips:

 

This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional health information, please contact the Center for Consumer Health Information at the Cleveland Clinic (216) 444-3771 or toll-free (800) 223-2273 extension 43771. If you prefer, you may visit www.clevelandclinic.org/health/ or www.clevelandclinicflorida.org. This document was last reviewed on: 5/2/2014

index#10302