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Spondylolisthesis: Back Condition and Treatment

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Welcome to the Explaining Spondylolisthesis article, which is designed to help you learn more about spondylolisthesis and how it is treated. It has been written by a group of expert doctors and nurses who are committed to helping patients, their families, and friends better understand various spinal conditions. While we are sure that you will find the article to be informative and enjoyable, please remember that the key element in your treatment will be to maintain close contact with your physician.

What Is Spondylolisthesis?

The word spondylolisthesis derives from two parts: spondylo which means spine, and listhesis which means slippage.

So, a spondylolisthesis is a forward slip of one vertebra (ie, one of the 33 bones of the spinal column) relative to another. Spondylolisthesis usually occurs towards the base of your spine in the lumbar area.

spondylolisthesis

This x-ray shows spondylolisthesis in the lumbar spine.  Look at where the arrow is pointing:  you can see that the vertebra above the arrow has slid out over the vertebra below it.

 

Spondylolisthesis Grades

Spondylolisthesis can be described according to its degree of severity. One commonly used description grades spondylolisthesis, with grade 1 being least advanced, and grade 5 being most advanced. The spondylolisthesis is graded by measuring how much of a vertebral body has slipped forward over the body beneath it.

 

 

 Grade 1
 25% of vertebral body has slipped forward

 

 Grade 2
 50%

 

 Grade 3
 75%

 

 Grade 4
 100%

 

 Grade 5
 Vertebral body completely fallen off (i.e.,spondyloptosis)

 

How Do People Get Spondylolisthesis?

Approximately 5%-6% of males, and 2%-3% of females have a spondylolisthesis.

It becomes apparent more often in people who are involved with very physical activities such as weightlifting, gymnastics, or football.

Males are more likely than females to develop symptoms from the disorder, primarily due to their engaging in more physical activities.

Although some children under the age of five may be pre-disposed towards having a spondylolisthesis, or may indeed already have an undetected spondylolisthesis, it is rare that such young children are diagnosed with spondylolisthesis. Spondylolisthesis becomes more common among 7-10 year olds. The increased physical activities of adolescence and adulthood, along with the wear-and-tear of daily life, result in spondylolisthesis being most common among adolescents and adults.

Types of Spondylolisthesis

Different types of spondylolisthesis may be caused in a various ways. Some examples are:

Developmental Spondylolisthesis:  This type of spondylolisthesis may exist at birth, or may develop during childhood, but generally is not noticed until later in childhood or even in adult life.

Acquired Spondylolisthesis:  Acquired spondylolisthesis can be caused in one of two ways:

  • With all of the daily stresses that are put on a spine, such as carrying heavy items and physical sports, the spine may wear out (ie, degenerate). As the connections between the vertebrae weaken, this may lead to spondylolisthesis.
  • A single or repeated force being applied to the spine can cause spondylolisthesis; for example, the impact of falling off a ladder and landing on your feet, or the regular impact to the spine endured by offensive linemen playing football.

What Symptoms Might I Notice?

Many people with a spondylolisthesis will have no symptoms and will only become aware of the problem when it is revealed on an x-ray for a different problem. However, there are several symptoms that often accompany spondylolisthesis:

  • Pain in the low back, especially after exercise
  • Increased lordosis (ie, swayback).
  • Pain and/or weakness in one or both thighs or legs
  • Reduced ability to control bowel and bladder functions
  • Tight hamstring musculature
  • In cases of advanced spondylolisthesis changes may occur in the way people stand and walk; for example, development of a waddling style of walking. This causes the abdomen to protrude further, due to the lowback curving forward more. The torso (chest, etc.) may seem shorter; and muscle spasms in the lowback may occur.
Updated on: 03/13/13
Christopher P. Silveri, MD
Professor Rodts has done an excellent job at distilling the basics of spondylolisthesis into a concise easy to read layman's format. Anatomy and natural history are well described with the help of visual aids.
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