What is spondylolisthesis?
Spondylolisthesis is a spinal condition caused by the displacement of a vertebra, where one of the small bones in the spine slips out of its normal position onto the vertebra beneath it. When slipped vertebrae occur in the lower back, it may be called lumbar spondylolisthesis. If slipped vertebrae occur in the cervical spine or neck, it may be called cervical spondylolisthesis.
In some cases, spondylolisthesis may cause no noticeable symptoms. However, some patients who have this condition may experience a range of symptoms, including mild to severe back and leg pain. Nonsurgical treatments are often effective in easing these symptoms. If there’s significant vertebra slippage that squeezes a nerve, surgical treatment may be required.
Penn Medicine’s expert orthopaedics team has deep experience in treating spondylolisthesis, and we understand how it can impact your quality of life. We offer a variety of treatment options, including pain management, physical therapy, and surgery to help relieve your pain and increase mobility. Our orthopaedics specialists will support you throughout your treatment journey, providing compassionate care at convenient locations in the southeastern Pennsylvania and New Jersey regions.
Types of spondylolisthesis
Spondylolisthesis occurs in various forms:
- Congenital spondylolisthesis arises from spine malformation at birth that increases the risk of future slipped vertebrae.
- Degenerative spondylolisthesis occurs when spinal osteoarthritis causes certain joints and discs to deteriorate over time.
- Dysplastic spondylolisthesis results from a vertebra defect, often present at birth, that leads to slippage.
- Isthmic spondylolisthesis is caused by repetitive trauma, common in athletes, and is often linked to fractures, including stress fractures.
- Pathologic spondylolisthesis is caused by bone diseases such as tumors or osteoporosis.
Spondylolisthesis symptoms and signs
Spondylolisthesis symptoms range from subtle to severe, with some patients showing no signs of the condition. Common symptoms of spondylolisthesis include:
- Buttock pain
- Leg pain (caused by pressure on nerve roots)
- Lower back pain
- Numbness or tingling that worsens with activity
- Tight muscles (especially hamstrings)
In more severe cases of spondylolisthesis, patients may experience additional symptoms including:
- Changes in bladder function
- Changes in posture or gait
- Difficulty walking
- Foot numbness
- Muscle spasms
- Pain when transitioning from sitting to standing
- Stiffness
What causes spondylolisthesis?
Spondylolisthesis has various causes depending on a patient’s age. In children, it’s typically due to a birth defect or sudden injury. Adults may experience spondylolisthesis from abnormal wear on cartilage and bones due to arthritis, fractures, tumors, trauma, or bone abnormalities.
Certain sports, such as gymnastics, weightlifting, and football, can stress the lower back bones leading to a stress fracture or weakening of the spine. Some exercises can also exacerbate spondylolisthesis such as lumbar extensions beyond the neutral position, prone press-ups, standing extensions, prone leg raises, and back extension machines at the gym. Overextending the spine is also a common cause of spondylolisthesis, particularly in young athletes. In older adults, degenerative spondylolisthesis is common, resulting from wear and tear on the spine and intervertebral discs over time.
Who is at risk of developing spondylolisthesis?
Spondylolisthesis is more prevalent in patients over age 50, in athletes, in those with genetic predispositions, and in individuals with degenerative spinal conditions. Several factors may contribute to the risk of developing spondylolisthesis:
- Age is a significant factor, as degenerative spine conditions, common in older adults, can weaken vertebrae.
- Genetics may play a role in some individuals born with thinner vertebrae sections, caused by conditions like pars interarticularis, which makes them more susceptible to fractures and slipped vertebrae.
- Young athletes, particularly in gymnastics and football, are also prone to this condition.
Patients with spondylolisthesis should generally avoid weightlifting, twisting, or bending exercises and high-impact activities like jumping rope. With proper treatment, you may return to these activities later. Your Penn Medicine care team will explain any precautions you should take and let you know when it’s safe for you to return to certain physical activities.
Diagnosing spondylolisthesis
To confirm whether you have spondylolisthesis, your doctor will give you a physical exam and review your medical history. You may be asked to perform certain movements to evaluate any pain or limitations. You’ll likely have some imaging tests to reveal any vertebra misalignment or fractures and to assess spinal canal narrowing and nerve compression. The severity of spondylolisthesis is often graded based on these imaging results.
Spondylolisthesis treatment
Spondylolisthesis typically doesn’t resolve on its own, but you can experience relief from its symptoms through rest, medication, and physical therapy. For milder cases, nonsurgical treatments may help ease pain, improve functionality, and prevent the condition from worsening. Surgery is an option if you are experiencing significant pain. Since spondylolisthesis is generally not life-threatening, treatment is a personal, quality-of-life decision. Your Penn Medicine care team can answer questions about your options and help determine the best treatment plan for you.
Expert spondylolisthesis and spine disorder care at Penn Medicine
When you receive care at Penn Medicine, you’ll work with our Spine Care experts who treat a large volume of patients with spondylolisthesis. We offer a range of surgical and nonsurgical approaches to help improve your mobility and live pain free. Our advanced treatments are based on the latest research, including minimally invasive options for those that need surgery.
Our multidisciplinary team includes specialists in orthopaedics, neurosurgery, neurophysiology, pain medicine, and physical medicine and rehabilitation. They work together to tailor treatment plans for even the most complex cases. This depth of experience allows our doctors to pinpoint your diagnosis accurately and provide treatment options that are backed by research and can offer the best outcomes.