DefinitionThe spine is made of several bones called vertebra. They are lined up so the spinal cord can run through the center of the bones. Spondylolisthesis is when one of the vertebrae (usually in the lower back area) slips out of place. It moves forward compared to the vertebra below and develops slowly over time.
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CausesSpondylolisthesis is most often caused by a stress fracture. The fracture can make the vertebra unstable and allow it to slip forward. This type of fracture often occurs when a lot of stress and pressure is put on the back. This can occur with certain sports activities. The condition can also be caused by spinal problems that are present at birth, like spina bifida .
Risk FactorsFactors that may increase your chance of spondylolisthesis include:
- Rapid growth
- Being an athlete, especially gymnasts, weight-lifters, and football players
- Family history
SymptomsSpondylolisthesis begins to progress at age 10-15 years. Symptoms may not appear until adulthood. In many cases of spondylolisthesis, there are no obvious symptoms. Symptoms that may be present include:
- Low back pain, which may feel like muscle strain
- Stiff back
- Muscle spasms of the hamstring
- Buttock pain and spasm
- Changes in posture and/or gait
- Numbness, weakness, or tingling around the pelvis, buttochs, or thighs
- Loss of bladder control
DiagnosisYour doctor will ask about your symptoms and medical history. A physical exam will be done. Images of the spine will be taken with:
TreatmentTalk with your doctor about the best treatment plan for you. Treatment options include:
Physical TherapyPhysical therapy usually involves exercise. The exercise will focus on strengthening the abdominal and back muscles. A back brace may also be recommended.If you are overweight, your doctor may recommend you lose weight. This will help reduce stress on the spine.
MedicationsPain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), may help manage pain.
SurgerySurgery may be needed if the bone has severly slipped or you do not respond to treatment. Surgery will fuse 2 of the vertebra together. The procedure is called spinal fusion .
PreventionTo help reduce your chance of spondylolisthesis:
- Exercise regularly.
- Get plenty of rest between workouts.
- Take measures to protect your back when participating in sports.
- Maintain a healthy weight.
North American Spine Society
Ortho Info—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Spondylolysis and spondylolisthesis. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00053. Updated October 2007. Accessed December 28, 2012.
Spondylolisthesis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 6, 2012. Accessed December 28, 2012.
- Reviewer: Michael Woods, MD
- Review Date: 12/2014
- Update Date: 12/20/2014