Isthmic Spondylolisthesis – How Can It Be Treated?

Spondylolisthesis is a spinal disorder where a vertebral body slips forward and out of its normal anatomical place. There are multiple types of spondylolisthesis, but cases of isthmic spondylolisthesis tend to be the most common ones.

This type of spondylolisthesis can be differentiated from other types due to its origin. Namely, it occurs due to a fracture of the pars interarticularis, a small bony formation that holds together the spinal facet joints. When this bony structure becomes damaged, it can lead to a fracture, allowing a vertebra to slip forward.

Spondylolisthesis can also be divided into multiple grades of severity based on how much a vertebral structure has moved out of its place. It encompasses 5 grades of vertebral slip, where grade I is the mildest form, and grade V represents high grade spondylolisthesis.

Isthmic Spondylolisthesis

Causes and Risk Factors

Some of the most common reasons (including causes and risk factors) why spondylolisthesis occurs include:

  • Having a genetic predisposition, where a failure of bone development makes the spine more fragile to external physical stressors, and as such it can become fractured more easily.
  • A complication of spondylolysis, a spinal condition where pars interarticularis becomes fractured.
  • Engaging in high-intensity sports. Due to the physical demands that certain sports can place on one’s body, this type of spondylolisthesis is also rather common among young athletes.
  • It can also affect people who engage in other types of physically-demanding activities that require frequent bending and twisting motions of the spine.


Isthmic spondylolisthesis tends to affect the lower back most often and as such some of its most common symptoms include:

  • Pain in the lower back due to nerve compression. The pain may worsen during physical activity.
  • In more severe cases, the pain can also spread from the lower back down the legs, causing leg pain and sometimes even foot pain.
  • Tight lower back or leg muscles, or even muscle spasms in these two regions.
  • Weakness in the lower back and/or legs.

Treatment Options

Before treating spinal problems, it is recommended that you get a diagnosis to correctly determine the cause of your symptoms. Additionally, working with medical professionals can also help you get a tailored treatment plan, depending on the severity of your condition.

Typically, milder cases of spondylolisthesis (up to grade III) can be addressed without surgery, whereas more severe cases might require surgical treatments.

If your symptoms are on the milder side, you may typically use a combination of the following to manage and/or fix the pain that you feel:

  • Physical therapy to improve the mobility and range of motion of your spine.
  • Apply a cold or hot pack to the affected region to reduce inflammation and pain.
  • Use a back support belt to reduce the load placed on your lower spine.
  • You may also wish to engage in spinal decompression therapy to stretch out your spine and reduce the effects of spinal compression.

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