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Medical Author:

Jason C. Eck, DO, MS

Jason C. Eck, DO, MS

Dr. Eck received a Bachelor of Science degree from the Catholic University of America in Biomedical Engineering, followed by a Master of Science degree in Biomedical Engineering from Marquette University. Following this he worked as a research engineer conducting spine biomechanics research. He then attended medical school at University of Health Sciences. He is board eligible in orthopaedic surgery.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• What is spondylolisthesis?
• What causes spondylolisthesis?
• What are the risk factors for spondylolisthesis?
• What are the symptoms of spondylolisthesis?
• How is spondylolisthesis diagnosed?
• What is the treatment for spondylolisthesis?
• Can spondylolisthesis be prevented?
• What are the complications of spondylolisthesis?
• What is the outlook for spondylolisthesis?
• Spondylolisthesis At A Glance
• Patient Comments: Spondylolisthesis - Symptoms
• Patient Comments: Spondylolisthesis - Effective Treatments
• Patient Comments: Spondylolisthesis - Causes
• Find a local Rheumatologist in your town
• Spondylolisthesis Index

Risk factors for spondylolisthesis include a family history of back problems. Other risk factors include a history of repetitive trauma or hyperextension of the lower back or lumbar spine. Athletes such as gymnasts, weight lifters, and football linemen who have large forces applied to the spine during extension are at greater risk for developing isthmic spondylolisthesis.

The most common symptom of spondylolisthesis is lower back pain. This is often worse after exercise especially with extension of the lumbar spine. Other symptoms include tightness of the hamstrings and decreased range of motion of the lower back. Some patients can develop pain, numbness, tingling or weakness in the legs due to nerve compression. Severe compression of the nerves can cause loss of control of bowel or bladder function, or cauda equina syndrome.

In most cases it is not possible to see visible signs of spondylolisthesis by examining a patient. Patients typically have complaints of pain in the back with intermittent pain to the legs. Spondylolisthesis can often cause muscle spasms, or tightness in the hamstrings.

Spondylolisthesis is easily identified using plain radiographs. A lateral X-ray (from the side) will show if one of the vertebra has slipped forward compared to the adjacent vertebrae. Spondylolisthesis is graded according the percentage of slip of the vertebra compared to the neighboring vertebra.

1. Grade I is a slip of up to 25%,
   
   
2. grade II is between 26%-50%,
   
   
3. grade III is between 51%-75%,
   
   
4. grade IV is between 76% and 100%, and
   
   
5. Grade V, or spondyloptosis occurs when the vertebra has completely fallen off the next vertebra.

If the patient has complaints of pain, numbness, tingling or weakness in the legs, additional studies may be ordered. These symptoms could be caused by stenosis or narrowing of the space for the nerve roots to the legs. A CT scan or MRI scan can help identify compression of the nerves associated with spondylolisthesis. Occasionally, a PET scan can help determine if the bone at the site of the defect is active. This can play a role in treatment options for spondylolisthesis as described below.