What is spondylolisthesis?
A vertebra that has moved forward, out of its normal position, relative to the bone below it.
MedlinePlus explains the common causes:
- Degenerative: in adults, wear of the cartilage and joints (arthritis) lets a vertebra slide. It mostly affects people over 50 and is more common in women.
- Stress fracture (isthmic): a crack in a thin bridge of bone at the back of the vertebra, called the pars interarticularis. It's linked to sports that repeatedly bend the back backward, such as gymnastics, weightlifting and football (AAOS).
- Congenital or injury-related: a birth difference in the spine, or a sudden injury.
A pars fracture without any slip is called spondylolysis (AAOS).
What are the symptoms?
Often none. When there are symptoms, low back pain and pain, numbness or tingling in the buttocks or thighs are common.
- Low back pain or stiffness that doesn't go away.
- Pain, numbness or tingling in the thighs and buttocks.
- Tenderness over the slipped vertebra.
- Tight hamstrings or a change in posture, in some people.
A slip can also narrow the spinal canal and cause spinal stenosis, with leg pain on walking (MedlinePlus).
Is it stable or unstable, and why does that matter?
Stability decides a lot. A vertebra that shifts with movement, or a pars fracture, makes stretching treatments risky.
Doctors describe a slip by how far it has moved, often graded from mild to severe, and whether it moves when you bend. Standing X-rays taken while bending forward and backward can show movement. An MRI or CT shows whether nerves are pinched (MedlinePlus).
| Finding | What it usually means for decompression |
|---|---|
| Unstable slip (moves on bending X-rays) | Not a candidate |
| Pars defect (stress fracture) | Not a candidate |
| Severe slip or nerve symptoms getting worse | Needs a spine specialist |
| Mild, stable degenerative slip with a disc problem | Possibly, only after exam and imaging review |
These rules follow the candidate guidelines Springville Disc Center publishes. See the full candidate list.
How is spondylolisthesis usually treated?
Most people do well with exercises that stretch and strengthen the low back, plus changes in activity.
Per MedlinePlus and AAOS, non-surgical care includes rest from aggravating activity, pain medicine, physical therapy and sometimes a brace. Follow-up X-rays check that the slip isn't progressing. Surgery to fuse the vertebrae may be needed for severe pain that doesn't improve, a slip that keeps worsening, or trouble controlling the bladder or bowels.
What happens if I ask about decompression?
You'll get a straight answer, which may be no.
Dr. Gordon Stapel, DC will review your history, examine you and look at your imaging reports, ideally including X-rays that show whether the slip moves. If decompression isn't appropriate, he'll tell you and point you toward options that are, including a referral. If you have a mild, stable slip alongside a disc problem, he'll explain the possible benefits, the limits of the research and what to expect. Call (801) 491-8688 or bring your reports to a free MRI review.
Spondylolisthesis FAQs
Can you have spinal decompression with spondylolisthesis?
What is spondylolisthesis?
Does spondylolisthesis always cause pain?
How is spondylolisthesis usually treated?
What tests show whether a slip is stable?
Ask whether decompression is appropriate
Prefer to talk now? Call (801) 491-8688. Or send this short form and the office will call you back during business hours, usually within 2 business days.
Sources
This website is operated for Stapel Family Chiropractic (Springville Disc Center) in Springville, Utah. Care is provided by Dr. Gordon Stapel, DC, a licensed chiropractic physician. About this site.