Spondylolisthesis (Slipped Vertebra)
Spondylolisthesis at a glance
- Spondylolisthesis is also called slipped vertebra or shifted spine occurs when a vertebra in the spine slips forward and backward from its correct position in relation to other vertebrae, usually in the lower back.
- A slipped vertebra is often caused by degenerative spondylolisthesis, which is more common in older people, or spondylolysis, more common in younger people.
- Depending on severity, spondylolisthesis may be treated by medication, physical therapy, or back surgery. If non-symptomatic, a patient may choose to not pursue treatment.
Causes of spondylolisthesis
Spondylolithesis can be caused by a vertebra being defective from birth, breaking due to a stress fracture or trauma, or discs degenerating from disease, infection, or old age. A fracture or defect in part of the vertebra (called spondylolysis) can cause the vertebra to slip forword, backward, side-to-side, or over the vertebra below.
Spondylolisthesis occurs due to multiple underlying conditions. The two most common are spondylolytic spondylolisthesis and degenerative spondylolisthesis.
Spondylolysis is more common in younger people, especially athletes, and is usually developed early on and present through life.
Degenerative spondylolisthesis generally affects people over age 60, occurring due to the natural spinal degeneration process that accompanies aging.
Symptoms of spondylolisthesis
Spondylolisthesis symptoms may include:
- Muscle weakness, numbness, tightness, and/or stiffness
- Back pain, often in the lower back
- Pain in the buttocks or hips
- Pain extending down through the legs or through other extremities (due to pressure on nerve roots)
Spondylolytic spondylolisthesis can sometimes cause weakness in the lower extremities, including the feet (foot drop).
Degenerative spondylolisthesis can be a crippling condition, with symptoms including those commonly associated with a pinched spinal nerve and inability to walk due to pain.
With back pain caused by spondylolisthesis, the affected area feels hot to the touch. Patients often describe the sensation as a burning pain, and may also experience sciatica.
Scoliosis (curvature of the spine) may also be present with spondylolisthesis.
Other conditions that can develop due to spondylolisthesis are: flat back, a posture change where the lower back becomes straight or flat and spinal instability where a segment of the spine moves too much, either side-to-side, front-to-back, or up and down.
Treatment of spondylolisthesis
Diagnosing spondylolisthesis in its earlier stages can help manage the condition, prevent more serious symptoms in the future, and can allow for less-invasive treatments.
Depending on severity, spondylolisthesis may be treated by medication, physical therapy and pain management, or surgery. If non-symptomatic, a patient may choose to not pursue treatment.
Medications may help with pain management or treat spondylolisthesis symptoms, such as anti-inflammatory drugs (like Advil) or epidural steroid injections. Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.
Physical therapy treatment options may include massages, core-strengthening exercises, spinal support (bracing), and traction. Pain management techniques can also include epidural injections.
If other treatment options do not improve the condition, surgery may be necessary or desirable. Minimally invasive repair surgery may be an option for less-advanced spondylolisthesis cases.
For advanced degeneration and spinal instability caused by spondylolisthesis, spinal fusion and other techniques may be necessary, including:
- Percutaneous spinal fusion (a minimally invasive procedure)
- Simple spinal fusion (without implants)
- Complex spinal fusion (with implants)
If you are experiencing back pain or other symptoms associated with spondylolisthesis, contact us to request an appointment with our orthopedic spine specialists to learn about treatment options available to you.