Spondylolisthesis
(Slipped Vertebra)
Definition
Spondylolisthesis is when one a vertebra (spinal bone) slips forward onto the vertebra below it. It happens slowly over time.
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Causes
Causes may be:
- Abnormal structure of the vertebrae that is present at birth, such as spina bifida
- Spondylolysis—a stress fracture in the spine that makes the vertebra unstable
- Wear and tear from the normal aging process
- Trauma
- Diseases, such as Marfan syndrome and Ehlers-Danlos syndrome
- Spinal surgery
Risk Factors
Things that may raise the risk of this problem are:
- Having a family member with this problem
- Having spondylolysis
Symptoms
Most people do not have symptoms. Those who do may have:
- Back pain and stiffness
- Pain that may spread down to the legs
- Muscle spasms in the back of the thighs
- Problems standing and walking
- Tingling, numbness, or weakness in one or both legs
Diagnosis
The doctor will ask about your symptoms and health history. A physical exam will be done.
Images may be taken of the spine. This can be done with:
Treatment
People who do not have symptoms may not need treatment. In others, the goal of treatment is to manage symptoms. Choices are:
- Supportive care, such as limiting activities to allow the area to rest
- Physical therapy to promote strength, flexibility, and range of motion in the back
- A back brace to stabilize the spine
- Medicines, such as:
- Pain relievers
- Muscle relaxants
People who are not helped by these methods may need surgery. It may also be done if the bone has severely slipped. Spinal fusion may be done to fuse two vertebrae together to stabilize the spine.
Prevention
There are no known guidelines to prevent this health problem.
RESOURCES:
North American Spine Society
http://www.spine.org
Ortho Info—American Academy of Orthopaedic Surgeons
http://www.orthoinfo.org
CANADIAN RESOURCES:
Canadian Orthopaedic Association
http://www.coa-aco.org
Canadian Orthopaedic Foundation
http://www.canorth.org
REFERENCES:
Abdu WA, Sacks OA, et al. Long-term results of surgery compared with non operative treatment for lumbar degenerative spondylolisthesis in the Spine Patient Outcomes Research Trial (SPORT). Spine (Phila Pa 1976). 2018;43(23):1619-1630.
Bouras T, Korovessis P. Management of spondylolysis and low-grade spondylolisthesis in fine athletes. A comprehensive review. Eur J Orthop Surg Traumatol. 2015 Jul;25 Suppl 1:S167-S175
Gould HP, Winkelman RD, et al. Epidemiology, treatment, and performance-based outcomes in American professional baseball players with symptomatic spondylolysis and isthmic spondylolisthesis. Amer J Sports Med. 2020;48(11):2765-2773.
Kukreja M, Hecht AC, et al. Spondylolysis and Spondylolisthesis in the Adolescent Athlete. Sem Spine Surg.Volume 32, Issue 3, 2020,100804, ISSN 1040-7383, https://doi.org/10.1016/j.semss.2020.100804.
Randall RM, Silverstein M, et al. Review of pediatric spondylolysis and spondylolisthesis. Sports Med Arthr Rev.2016;24(4):184-187.
Spondylolisthesis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/spondylolisthesis. Accessed February 18, 2021.
Spondylolysis and spondylolisthesis. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/spondylolysis-and-spondylolisthesis. Accessed February 18, 2021.
Last reviewed December 2020 by EBSCO Medical Review Board Laura Lei-Rivera, PT, DPT Last Updated: 2/18/2021