Spondylolisthesis is a condition where one of the bones in your spine slides forward over the bone below it. This can push on nearby nerves and cause pain in your lower back, buttocks or legs. Some people don’t feel any symptoms, but for others, it can make everyday activities harder—especially if it happens along with problems like spinal stenosis or cervical spondylosis.
If you have spondylolisthesis, turn to the experts at Summit Orthopedics in Minneapolis/St. Paul for help.
Types of Spondylolisthesis
Spondylolisthesis can develop in different ways, depending on the underlying cause. For some people, it’s related to a small fracture from overuse or injury. For others, the wear and tear is part of the natural aging process. Understanding which type you have is an important step in finding the most effective treatment and relief.
Isthmic Spondylolisthesis
This type is caused by a small crack in a vertebra, often in the lower back. Over time, the bone can weaken and shift forward.
Degenerative Spondylolisthesis
This form happens as the spine ages. Discs lose height, and joints and ligaments become less stable. Degenerative spondylolisthesis is more common in older adults and may occur in the cervical or lumbar spine. It often appears alongside cervical spondylosis or spinal stenosis.
Common Symptoms
Spondylolisthesis doesn’t always cause symptoms. People may not even realize they have it. But when symptoms do appear, they can range from mild discomfort to more serious nerve-related pain. Paying attention to how your body feels can guide you toward the right treatment. Here are some symptoms to keep an eye on:
- Lower back or neck pain
- Muscle weakness or changes in posture
- Numbness or tingling in the legs or buttocks
- Pain or tightness in the legs or hamstrings (sciatica)
- Trouble walking or standing for long periods
Symptoms often get worse with activity and feel better with rest.
Spondylolisthesis Diagnosis
Your provider will start with a physical exam and ask about your symptoms. You may also need one of the following imaging tests:
- CT scans to look at bone detail and bone spurs
- MRI scans to view discs, nerves and soft tissue
- X-rays to check for slipping vertebrae
Nonsurgical Treatment Options
Surgery is not always needed. Many people feel better with:
- Anti-inflammatory medications
- Guided exercise plans
- Lifestyle changes, such as avoiding heavy lifting
- Physical therapy to build strength and ease nerve pressure
- Short-term use of a back brace
- Steroid injections to reduce inflammation
Try to maintain good posture, avoid tobacco and work with a physical therapist to protect your spine.
Surgical Treatment
Surgery is usually not the first option for treating spondylolisthesis. However, if nonsurgical treatments don’t work—or if nerve pressure causes a lot of pain, weakness or trouble walking—your doctor may suggest surgery. The purpose of surgery is to steady the spine, take pressure off the nerves and fix the alignment of the bones.
The most common surgery for spondylolisthesis is spinal fusion. This procedure connects two or more bones in your spine to stop movement in the problem area. Your doctor will decide the best way to do the surgery based on how severe your condition is, where the slippage happened and your overall health. Common surgical procedures include:
- Anterior lumbar interbody fusion (ALIF): This approach is done from the front, through the abdomen, to reach and stabilize the spine.
- Oblique lumbar interbody fusion (OLIF): This is done at an angle from the side, avoiding major back muscles and causing less damage to tissues.
- Posterolateral spinal fusion: This surgery that uses bone grafts placed next to the spine to join the bones but keeps the disc in place.
- Transforaminal lumbar interbody fusion (TLIF): This surgery is done from the back. It involves taking out the disc and putting a spacer and bone graft between the spine bones.
Each type of surgery has its own benefits based on how the doctor gets to your spine and how your body is shaped. Your doctor will talk with you about the choices to find the safest and best option for you.
Recovery times can be different for everyone, but most patients feel less pain and more stable in the long term after the surgery.
Managing Pain from Spondylolisthesis
Your care team may suggest a combination of treatments, such as:
- Injections for targeted relief
- Over-the-counter nonsteroidal anti-inflammatory drugs
- Physical therapy and at-home stretches
- Rest and gentle movement
Spondylolisthesis Care at Summit Orthopedics
Summit Orthopedics surgeons are available at nearly 30 convenient locations across the Minneapolis/St. Paul metro area, serving Minnesota and western Wisconsin. Our state-of-the-art, comprehensive orthopedic centers offer same-day appointments from a team of experts who offer the full scope of orthopedic care, including care for spondylolisthesis.
Find your Summit Orthopedics spine expert, request an appointment or call us at (651) 968-5201 to schedule a consultation.
