What is Spondylolisthesis?
Spondylolisthesis is a condition in which one of the vertebrae (bones) in the spine slips out of its proper position on the vertebra either above or below. The word spondylolisthesis is derived from the Greek words "spondylo," meaning spine, and "listhesis," meaning to slip. Spondylolisthesis can occur in people of all ages and for different reasons. Its cause and severity will determine the course of treatment.
Types and Causes of Spondylolisthesis
There are different kinds of spondylolisthesis that vary in their cause and the age group they most often affect.
This is the most common type of spondylolisthesis in adults. Slipping of a vertebra is caused by the normal wear and tear of aging that affects the spinal discs and joints. The attachments between two adjacent vertebrae become weakened, increasing the chance of slippage. The most common location of degenerative spondylolisthesis is between the fourth and fifth lumbar vertebrae (L4 and L5).
This kind of spondylolisthesis most common in adolescents and young adults, especially among those who participate in sports that stress the back—such as gymnastics or football. The slippage most commonly occurs between the fifth lumbar and first sacral vertebrae (L5 and S1), although it may occur at higher levels in the lower spine. It is caused by a stress fracture in the back portion of the spine (pars interarticularis). Even though these fractures usually occur in young people, symptoms may not occur until many years or even decades later. Learn about the symptoms and causes of spondylolysis.
Congenital (dysplastic) spondylolisthesis
Congenital spondylolisthesis most often affects children and teenagers. It occurs when a birth defect causes the bones of the spine to grow abnormally. When this happens, the misaligned spine puts pressure on the disc, resulting in slippage. It typically happens in the lower lumbar and sacral spine and can be associated with other genetic or inherited syndromes.
This kind of spondylolisthesis occurs when an acute, traumatic injury causes a fracture, leading the vertebra to slip out of alignment. Examples of events that could cause spondylolisthesis include motor vehicle accidents, serious falls, and high-impact sports injuries.
This kind of vertebral slipping may occur rarely during spinal surgery ("post-surgical spondylolisthesis"). The surgeons at Och Spine at NewYork-Presbyterian are highly experienced in performing "revision" surgery: repair of a previous surgery that did not have a positive outcome
This kind of condition is associated with another condition that affects the spine, such as spinal tumors, infections, or certain bone or inflammatory conditions that weaken the spine joints and ligaments, increasing the risk of slippage.
Risk Factors for Spondylolisthesis
You may have an elevated risk of spondylolisthesis due to:
- Older age, which causes degeneration of the spine.
- Participation in sports that stress the spine, such as football, gymnastics, and weightlifting.
- Inherited factors that result in an abnormality in your spinal anatomy and raise the chance of a slipped vertebra.
- Have a spinal tumor or other spine condition that weakens the spine joints and ligaments.
Many people with spondylolisthesis have no symptoms at all. When symptoms occur, they typically affect the area directly around the slipped vertebra.
Pain or irritation at the level of the slippage in your spine may cause you to feel back pain.
Pain while walking
Your back pain may feel worse when standing, walking, or moving around in general. The pain may also radiate into your leg and hip if the slipped vertebra aggravates a nerve root, causing radiculopathy (sciatica is an example).
Very rarely, when spondylolisthesis in a man's lumbar spine causes irritation of a nerve root, such as a pinched nerve, the pain can radiate into the testicles and cause testicular discomfort.
Loss of balance
The slippage of a vertebra can result in pain, numbness, tingling, or tenderness in the area that may make it challenging to keep your balance—especially if there is pressure on the spinal cord.
What Happens if Spondylolisthesis Is Left Untreated?
Some people may not need any treatment for their spondylolisthesis if it is mild, does not cause significant symptoms, and is not getting worse. But if your spondylolisthesis is causing you discomfort that keeps you from doing the activities you enjoy, makes ordinary movement such as standing and walking difficult, or is getting worse, see a doctor to receive spondylolisthesis diagnosis and treatment.
You should seek medical attention quickly if you experience:
- Numbness, weakness, or tingling, including discomfort that travels down into your buttocks, hips, and legs
- Difficulty walking or balancing
- Loss of bladder or bowel control
Find Treatment for Spondylolisthesis at Och Spine at NewYork-Presbyterian
If you have symptoms that suggest you may have spondylolisthesis, a visit to a spine specialist can determine the cause and the most effective treatment.
The experts at Och Spine treat every type of spinal condition, from the mildest to the most severe, using non-surgical and surgical methods. Our team will assess your symptoms and function and match you with the care that is most appropriate for you so you can start feeling better sooner.
Every doctor at Och Spine has experience in various back and neck conditions and injuries. When you call us to make an appointment, we will work with you to identify the best physician for your specific need.
Contact us to make an appointment.