Spondylolisthesis comes from the Greek language – “spondylos”, meaning vertebra and “olisthesis”, meaning a slip. This means that one vertebrae moves forward compared to the adjacent vertebra. This commonly occurs in the lower back (lumbar spine) but may also occur in the neck (cervical spine).
This instability results in symptoms of back pain, pain in thighs or lower legs and symptoms of numbness or tingling. Patients may also suffer from symptoms of shooting pain (sciatica) or heaviness in legs or even weakness. When these symptoms develop it is often due to both spondylolisthesis and spinal stenosis (pressure on the spinal nerves). Many patients however have no symptoms and spondylolisthesis is only found when lumbar spine xrays are done.
There are several causes of spondylolisthesis. Commonly it develops due to degeneration of the lumbar disc and the joints of the lumbar spine (facet joints). A second common cause is due to a congenital (present at birth) defect in the lumbar spine or one that develops during adolescence.
Your doctor will ask you about your symptoms and perform a physical exam. X-rays and possibly an MRI or CT scan will be obtained to further diagnose your condition.
The first-line of treatment is improving your strength and flexibility through physical therapy. Anti-inflammatory medication can help during an episode of severe pain. For patients who have both spondylolisthesis and spinal stenosis (pressure on the spinal nerves), an injection (epidural injection) can offer symptom relief.
Surgery is reserved for patients who have exhausted all nonoperative treatment and still suffer from symptoms due to the instability of spondylolisthesis.