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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 - Effective Treatments
• Patient Comments: Spondylolisthesis - Symptoms
• Patient Comments: Spondylolisthesis - Causes
• Find a local Rheumatologist in your town
• Spondylolisthesis Index

The initial treatment for spondylolisthesis is conservative and based on the symptoms.

• A short period of rest or avoiding activities such as lifting and bending and athletics may help reduce symptoms.
  
  
• Physical therapy can help to increase range of motion of the lumbar spine and hamstrings as well as strengthen the core abdominal muscles.
  
  
• Anti-inflammatory medications can help reduce pain by decreasing the inflammation of the muscles and nerves.
  
  
• Patients with pain, numbness and tingling in the legs may benefit from an epidural steroid (cortisone) injection.
  
  
• Patients with isthmic spondylolisthesis may benefit from a hyperextension brace. This extends the lumbar spine bringing the two portions of the bone at the defect closer together and may allow for healing to occur.

For patients whose symptoms fail to improve with conservative treatment surgery may be an option. The type of surgery is based on the type of spondylolisthesis. Patients with isthmic spondylolisthesis may benefit from a repair of the defective portion of the vertebra, or a pars repair. If an MRI scan or PET scan shows that the bone is active at the site of the defect it is more likely to heal with a pars repair. This involves removing any scar tissue from the defect and placing some bone graft in the area followed by placement of screws across the defect.

If there are symptoms in the legs the surgery may include a decompression to create more room for the exiting nerve roots. This is often combined with a fusion that may be performed either with or without screws to hold the bone together. In some cases the vertebrae are moved back to the normal position prior to performing the fusion, and in others the vertebrae are fused where they are after the slip. There is some increased risk of injury to the nerve with moving the vertebra back to the normal position.