This usually occurs in your lower back but can also occur in your neck or mid to upper back. A slipped vertebra can put pressure on the nerves in your spinal canal, which connect your brain and your body. This can cause pain, pinching, numbness and weakness, usually in your lower back and legs.
Spondylolisthesis is not the same as a slipped disc — a slipped disc refers to one of the fluid-filled cushions between your vertebrae slipping out of position.
Spondylolisthesis is pronounced spohn-di-low-less-THEE-sis. In Greek, spondylos means spine or vertebra and listhesis means movement, sliding or slipping.
Spondylolysis and spondylolisthesis both cause lower back pain but they are not the same condition.
Spondylolysis is caused by a bone defect in your spine, which is usually caused by a stress fracture. It is common in young athletes.
Spondylolisthesis is caused by a vertebra slipping out of place and putting pressure on the vertebra below it as well as the nerves that run through the spinal canal.
However, spondylolysis can cause spondylolisthesis if the stress fracture results in the vertebra slipping.
Spondylolisthesis is most common in your lower back and might cause these symptoms:
If you have difficulty walking and feel unsteady on your feet, this may also be a sign.
It's possible to have spondylolisthesis without any of these symptoms.
You should see your GP if:
Your GP may examine your back, although spondylolisthesis doesn’t usually cause any visible symptoms. They may also examine your limbs to see the amount of movement and pain you have. This may include a straight leg test — this involves lying on your back while your GP holds your foot and gently lifts your leg up while you keep your knee straight.
You may need an X-ray while standing to see if you have a slipped vertebra in your spine or a spinal fracture. If you have numbness, weakness or tingling in your legs, you may also need an MRI scan or CT scan to detect if your slipped vertebra is compressing a nerve.
There are different causes of spondylolisthesis:
Types of spondylolisthesis
The three most common types of spondylolisthesis are:
Less common types of spondylolisthesis include:
Your risk of developing spondylolisthesis is greater if:
The treatment you receive will depend on the severity of your symptoms and how much they are affecting your quality of life. In most cases, your doctor will recommend non-surgical treatments first, such as:
These treatments provide temporary relief and during this time, your symptoms may go away on their own.
Your doctor will usually only recommend back surgery if:
The type of back surgery you have will depend on what type of spondylolisthesis you have. This could be:
These are major surgeries and you will need to stay in hospital for up to a week. It will take months for a full recovery.
Surgery usually relieves many spondylolisthesis symptoms, including pain and numbness in the legs. However, there are risks of complications, including:
Your doctor or surgeon will discuss the details of your surgical options and the risks involved before you make a decision.
Will spondylolisthesis come back?
In most cases, pain caused by spondylolisthesis goes away after recovering from spondylolisthesis surgery. Over time, you can return to your normal activities and regain full function and movement.
Spondylolisthesis can cause cauda equina syndrome. At the base of your spinal cord is a collection of nerves called the cauda equina. In cauda equina syndrome, these nerves are compressed, which can cause loss of feeling in your legs and bladder problems. It is a medical emergency. If it is not treated it can cause urinary incontinence and paralysis.
In some cases, spondylolisthesis comes back but this is usually if your first instance of spondylolisthesis was severe ie your vertebra moved considerably out of its normal position.
However, after spondylolisthesis surgery, most people return to normal activities after a recovery period, although your spine will be less flexible.
How do you fix spondylolisthesis?
Spondylolisthesis can be treated without surgery by using anti-inflammatory painkillers, physiotherapy and with rest. In some cases, you may need steroid injections. However, if these treatments are not effective, back surgery may be recommended.
Is spondylolisthesis serious?
Spondylolisthesis can be mild, moderate or severe. Severe cases of spondylolisthesis can be serious as they may lead to cauda equina syndrome, which is a medical emergency — if this condition is not treated it can cause urinary incontinence and paralysis. Even moderate cases, over time, if left untreated, can cause nerve damage if a nerve is compressed. You should therefore see your GP if you are concerned that you have spondylolisthesis as there are effective treatments.
What is the difference between spondylolysis and spondylolisthesis?
Both conditions can cause lower back pain. However, the underlying cause is different. Spondylolisthesis is caused by a bone in your spine (vertebra) slipping out of place, whereas spondylolysis is caused by a defect in your vertebra, which is usually caused by a stress fracture.
Is walking bad for spondylolisthesis?
Walking is not bad for spondylolisthesis as long as it doesn’t worsen your pain. Walking and other exercises that do not bend or strain your back can help strengthen your back and abdominal muscles, which can reduce your pain and improve your range of motion.
Can chiropractic help spondylolisthesis?
A chiropractor can’t fix your spondylolisthesis — they can’t push the slipped vertebra back into place. However, they can improve your range of movement and reduce your pain by focusing on the rest of your spine.
What should you not do with spondylolisthesis?
You should not take part in activities that strain or stretch your back, such as athletics, bending, lifting and football.
Can you become paralyzed from spondylolisthesis?
If a nerve is compressed, over time, spondylolisthesis can cause nerve damage, which may lead to paralysis. In some cases, spondylolisthesis can cause cauda equina syndrome — another spinal condition that is a medical emergency because if it is left untreated there is a high risk of paralysis.
Can you live with spondylolisthesis without surgery?
Yes, in many cases, spondylolisthesis can be effectively treated with non-surgical interventions, such as physiotherapy, resting your back, taking painkillers and/or steroid injections.
How should I sleep with spondylolisthesis?
Sleeping on your back in a reclining position can help reduce the pressure on your spine caused by the slipped vertebra ie sleeping propped up on several pillows.
When should you have surgery for spondylolisthesis?
If you have tried non-surgical treatments for spondylolisthesis (rest, physiotherapy, painkillers and steroid injections) and they have not worked, then surgery may be recommended. Your doctor may also recommend surgery if a nerve is compressed or your symptoms are persistent and severe.
Can you live a normal life after spinal fusion?
After a period of recovery, you can return to your normal activities. However, you will have reduced flexibility in the area of your spine where the vertebrae were fused.
Can spondylolisthesis cause bowel problems?
If spondylolisthesis is causing severe compression of a nerve, this can cause bowel incontinence.
Does spondylolisthesis get worse over time?
This depends on the severity and type of spondylolisthesis you have. Over time, symptoms of mild spondylolisthesis may go away on their own. However, in other cases, symptoms can get worse eg if a nerve is compressed or if you have degenerative spondylolisthesis.