What You Need to Know About Spondylolisthesis

What is Spondylolisthesis?

Spondylolisthesis is a spinal condition where one or more vertebrae, a cylindrical-shaped bony segment of the spinal column, slips out of its anatomical space.

The slippage of vertebrae can cause symptoms such as pain along the spine or limbs, stiffness, reduced mobility of the spine and sometimes even altered posture. Many of these symptoms can be managed through non-invasive treatment methods, which are listed below.

Spondylolisthesis Causes, Types, and Severity

Spondylolisthesis can be classified based on the primary factor that led to its development. There are several types of spondylolisthesis, some of which are:

  • Degenerative spondylolisthesis, caused by degeneration of spinal structures.
  • Traumatic spondylolisthesis, which occurs as a result of sudden physical injury to the spine that causes one or more vertebral bodies to move out of their designated anatomical space.
  • Congenital, a type that occurs as a result of a birth defect where the spine did not form correctly.
  • Isthmic spondylolisthesis, which results due to a fracture of a bony structure called the ‘pars interarticularis’, which is responsible for holding together the joints of the spine, also known as facet joints. When this bony formation is fractured, it can no longer hold the vertebral body in place, and as a result, this can slip out of its place.
  • Pathologic spondylolisthesis, as the name suggests, is caused by a different pathology that affects the spine.

Spondylolisthesis can also appear as an aftermath of spinal surgery, or due to a spinal issue called spondylolisis. Although similar in nomenclature, spondylolisthesis and spondylolysis are two separate conditions, where the latter could lead to the slippage of a vertebral body.

Apart from these types of spondylolisthesis, this condition also presents five degrees of severity, which denote the degree to which a vertebra has slipped. These grades of severity are as follows:

  • Grade 1 – A slippage of up to 25% from its original position.
  • Grade 2 – A slippage of between 26-50% from the original position.
  • Grade 3 – A slippage of 51-75%.
  • Grade 4 – A slippage of 76-100%.
  • Grade 5, also referred to as spondyloptosis, consists of the vertebral body completely slipping out.

Any type of spondylolisthesis previously mentioned tends to present one of these grades of severity.

Spondylolisthesis Symptoms

Some of the most noticeable symptoms of spondylolisthesis include pain and stiffness along the spine for people with mild spondylolisthesis, but there are additional symptoms that can appear in people who suffer from more severe cases. They are listed below:

  • Back or neck pain, depending on the region of the back that has been affected. Most often, it is the lumbar spine that is affected. When this region of the back is affected, it can be referred to as lumbar spondylolisthesis.
  • Stiffness and reduced range of motion in terms of bending and twisting the spine.
  • Weakness in the spine, neck, legs, or arms.
  • Numbness or tingling in the back, neck, or limbs.
  • Muscle problems, such as muscle tightness or muscle spasms.
  • Altered posture, especially in the lower spine, which may also lead to walking difficulties and changes in gait.
  • Loss of control over one’s bladder or bowels due to pinching of spinal nerves or the spinal cord.

Spondylolisthesis Complications

When a vertebra slips out of its place, it can obstruct the spinal canal, potentially leading to spinal stenosis. It can also slip onto one or more spinal nerves, trapping them, rubbing against them, and irritating them, which can lead to pain and other symptoms. In some cases, the spinal cord can also be affected, as the vertebra slips far into the spinal canal.

Additionally, it can lead to a condition called anterolisthesis, where a vertebra falls in a position that is in front of the one right underneath it.


In many cases, the treatment of this condition depends largely on the degree of severity as well as the cause. For severe spondylolisthesis, surgical intervention may be required, whereas for lower degrees of severity, symptoms can be managed through one or more non-invasive approaches, such as:

  • Pain relieving medication to lessen the pain.
  • Similarly, anti-inflammatory and pain-relieving topical creams can be used.
  • Applying ice packs or heated pads to the affected area to reduce inflammation and pain.
  • Physiotherapy.
  • Stretching of the back to release tension.
  • Spinal mobilisation through spinal decompression therapy, a non-invasive, yet highly effective treatment modality that allows you to take full control of your recovery.

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