Spondylolisthesis happens when a spinal bone (called a vertebra) slips forward onto the bone beneath it. If the vertebral bone slips far enough out of place, it can place pressure on surrounding discs, nerves, muscles, and other tissues. This can lead to a variety of symptoms including lower back pain that is worse with activity and better with rest; back stiffness; muscle spasms; buttocks and leg pain that is worse in standing; numbness and tingling in the legs and feet; and hamstring tightness or tenderness.
Spondylolisthesis often happens due to trauma, degenerative conditions, and overuse injury. It typically occurs in the lower back but can happen anywhere in the spine. It most often presents in younger active people, including weightlifters, football players, rowers, and gymnasts.
Frequently, spondylolisthesis is preceded by a similar but different condition called spondylolysis. In spondylolysis, a vertebral bone sustains a stress fracture, often due to similar trauma or overuse patterns. If left untreated, the stress fracture can cause the bone to become so weak that it slips out of place, leading to spondylolisthesis.
Spondylolisthesis does not always cause pain. Even severe forward bone slippage does not always present with symptoms, and may only be discovered after an x-ray is performed for some other condition. Spondylolisthesis may also be diagnosed through CT scans and physical examinations. MRI scans may also be helpful to determine if vertebral discs and other soft tissue structures are damaged as a result of the bone slippage.
At Indiana Spine Center, we work with many people diagnosed with spondylolisthesis. Our treatment approach includes non-surgical techniques—rest, chiropractic care, medication, back bracing, and spinal rehabililtation—to promote tissue healing and reduce symptoms. In cases with severe or worsening bone slipping, or for people with symptoms that do not improve after non-surgical treatment, a lumbar spinal fusion may be the most appropriate approach.
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