Anatomy:

The term spondylolisthesis simply means slippage of the spine. Normally the spine is made up of bony blocks called vertebrae stacked on top of each other to make up the spinal column. These vertebrae are usually in-line with each other. When one vertebra is “slipped” forward or backwards when compared to the one next to it, you have a spondylolisthesis.

There are several types of spondylolisthesis which include congenital (born with the slippage), traumatic (result of fracture of the spine), or degenerative (with aging/wear and tear there is some laxity in the spine’s stability and the vertebra can slip). This condition most commonly involves one of the lower three vertebrae in your back.

It is not uncommon to see a spondylolisthesis in an older patient. This occurs as a result of aging. The disc will narrow and cause some laxity in the spine allowing for some slippage. This slippage is usually stable and not progressive.

Depending on the degree of slippage, we as spine surgeons will grade the condition (Grade 1 – 4)

Signs and Symptoms:

As with many spinal conditions, a person with a spondylolisthesis may not have any symptoms. Those who are symptomatic from this condition may experience low back pain and/or leg pain. The slippage can occur such that one may experience the signs and symptoms similar to spinal stenosis or the slippage may cause pressure on a particular nerve such that you experience symptoms similar to a herniated disc.

These patients often will have associated low back pain in addition to any leg symptoms.

Treatment:

Treatment usually consists of non-steroidal anti-inflammatory medications (NSAIDs). As symptoms resolve, a good back exercise program can be quite beneficial.

If one’s symptoms persist despite conservative treatment, then further testing may be required. For the small number of patients that do not respond to conservative treatment, have progression of their slippage, or are unstable as determined by x-ray, lumbar fusion usually provides good relief. The fusion will often be combined with internal fixation. Dr. Irby will determine if you need fixation and will discuss this will you prior to surgery.