Skip to main content

Health Encyclopedia

Search the Health Encyclopedia

Spondylolisthesis

Definition

Spondylolisthesis is a condition in which a bone (vertebra) in the spine moves forward out of the proper position onto the bone below it.

Alternative Names

Low back pain - spondylolisthesis; LBP - spondylolisthesis; Lumbar pain - spondylolisthesis; Degenerative spine - spondylolisthesis

Causes

In children, spondylolisthesis usually occurs between the fifth bone in the lower back (lumbar vertebra) and the first bone in the sacrum (pelvis) area. It is often due to a birth defect in that area of the spine or sudden injury (acute trauma).

In adults, the most common cause is abnormal wear on the cartilage and bones, such as arthritis. The condition mostly affects people over 50 years old. It is more common in women than in men.

Bone disease and fractures can also cause spondylolisthesis. Certain sports activities, such as gymnastics, weightlifting, and football, greatly stress the bones in the lower back. They also require that the athlete constantly overstretch (hyperextend) the spine. This can lead to a stress fracture on one or both sides of the vertebra. A stress fracture can cause a spinal bone to become weak and shift out of place.

Symptoms

Symptoms of spondylolisthesis may vary from mild to severe. A person with spondylolisthesis may have no symptoms. Children may not show symptoms until they're 18 years old.

The condition can lead to increased lordosis (also called swayback). In later stages, it may result in kyphosis (roundback) as the upper spine falls off the lower spine.

Symptoms may include any of the following:

  • Lower back pain
  • Muscle tightness (tight hamstring muscle)
  • Pain, numbness, or tingling in the thighs and buttocks
  • Stiffness
  • Tenderness in the area of the vertebra that is out of place
  • Weakness in the legs

Exams and Tests

Your health care provider will examine you and feel your spine. You will be asked to raise your leg straight out in front of you. This may be uncomfortable or painful.

X-ray of the spine can show if a bone in the spine is out of place or broken.

CT scan or MRI scan of the spine can show if there is any narrowing of the spinal canal. 

Treatment

Treatment depends on how severely the vertebra has shifted out of place. Most people get better with exercises that stretch and strengthen lower back muscles.

If the shift is not severe, you can play most sports if there is no pain. Most of the time, you can slowly resume activities.

You may be asked to avoid contact sports or to change activities to protect your back from being overextended.

You will have follow-up x-rays to make sure the problem is not getting worse.

Your provider may also recommend:

  • A back brace to limit spine movement
  • Pain medicine (taken by mouth or injected into the back)
  • Physical therapy

Surgery may be needed to fuse the shifted vertebrae if you have:

  • Severe pain that does not get better with treatment
  • A severe shift of a spine bone
  • Weakness of muscles in one or both of your legs
  • Difficulty with controlling your bowels and bladder

There is a chance of nerve injury with such surgery. However, the results can be very successful.

Outlook (Prognosis)

Exercises and changes in activity are helpful for most people with mild spondylolisthesis.

Possible Complications

If too much movement occurs, the bones may begin to press on nerves. Surgery may be necessary to correct the condition.

Other complications may include:

  • Long-term (chronic) back pain
  • Infection
  • Temporary or permanent damage of spinal nerve roots, which may cause sensation changes, weakness, or paralysis of the legs

When to Contact a Medical Professional

Call your provider if:

  • The back appears to curve a lot
  • You have back pain or stiffness that does not go away
  • You have pain in the thighs and buttocks that does not go away
  • You have numbness and weakness in legs

References

Earle JL, Siddiqui IJ, Rainville J, Keel JC. Lumbar spondylolysis and spondylolisthesis. In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 49.

Lauerman W, Russo M. Thoracolumbar spine disorders in adults. In: Miller MD, Thompson SR, eds. DeLee & Drez's Orthopaedic Sports Medicine. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 128.

Review Date:9/22/2016
Reviewed By:C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

adam.com

The Agency for Health Care Administration (Agency) and this website do not claim the information on, or referred to by, this site is error free. This site may include links to websites of other government agencies or private groups. Our Agency and this website do not control such sites and are not responsible for their content. Reference to or links to any other group, product, service, or information does not mean our Agency or this website approves of that group, product, service, or information.

Additionally, while health information provided through this website may be a valuable resource for the public, it is not designed to offer medical advice. Talk with your doctor about medical care questions you may have.

Health
Outcome Data

Hospitalizations, length of stay, charges, and readmission rate for Back Problems


Read More

Kyphosis *

Lordosis - lumbar *


* Has Related Health Outcome Information

Health Encyclopedia

More Features

We Appreciate Your Feedback!
1. Did you find this information useful?
         Yes
         No
2. Would you recommend this website to family and friends?
         Yes
         No