Spondylolisthesis is a common cause of back and leg pain in both adolescents and adults. The condition occurs when a defect in a part of the spine causes a vertebra to slip forward and slide over the bone below it. Spondylolisthesis most commonly occurs in the lower back, or lumbar spine, but may develop in the neck and middle back as well.
Spondylolisthesis can cause tremendous pressure on the spinal cord and surrounding nerves, which leads to intense pain and discomfort.
At Neurosurgery One (formerly South Denver Neurosurgery), our neurosurgeons are experts at both surgical and non-surgical spondylolisthesis treatment.
Risk Factors of Spondylolisthesis
There are several different types of spondylolisthesis, and the cause of the condition may be related to the type. While spondylolisthesis occurs more frequently in older adults as the result of wear and tear, spondylolisthesis resulting from trauma is one of the more common causes of back pain in adolescents.
Overall, some of the most common risk factors include:
- Overuse and wear and tear on the affected joint
- Frequent, improper movements or lifting
- Degenerative disc disease
- Smoking and excessive alcohol consumption
- Sudden injuries resulting from manual labor, high-impact sports, or falls
- Bone abnormalities present at birth
Common Symptoms of Spondylolisthesis
Some people who have spondylolisthesis experience no symptoms. Among those who do, symptoms can be extremely varied. Some of the most common symptoms include:
- Chronic low back pain or neck pain
- Leg/arm pain
- Pain, numbness and weakness in the calves, buttocks, and/or thighs, often caused by standing or walking for long periods
- Pain that is relieved with sitting, especially in a reclining position
- Fatigue in the legs/arms
- In adolescents, spondylolisthesis resulting from high-impact trauma may cause a noticeable curve or sway in the lower back
Non-surgical Treatments for Spondylolisthesis
Spondylolisthesis typically is first treated with non-invasive therapies including:
- Ice. Cold packs or ice applied to the area may reduce inflammation and relieve pain.
- Steroid injections. A steroid injection can provide temporary pain relief.
- Physical therapy. Your physician may suggest physical therapy, possibly along with pain-relieving steroid injections so that exercises can be done with minimal discomfort.
- Pain medications. Over-the-counter pain relievers, such as acetaminophen (Tylenol), and non-steroidal anti-inflammatory medicines such as ibuprofen or aspirin may be useful for chronic pain. Prescription pain relievers may be necessary during episodes of extreme pain but are not recommended for long-term relief.
Learn more about non-surgical treatments.
Surgery to Relieve Pain Caused by Spondylolisthesis
At Neurosurgery One, our Denver spine neurosurgeons generally recommend spine surgery for less severe cases of spondylolisthesis if the condition causes pain that is not adequately relieved by more conservative treatments after six to 12 months. For patients with a grade 3 spondylolisthesis (50 to 75 percent slippage) or grade 4 (more than 75 percent), if conservative treatments are not working after three to six months, surgery may be the best option. One exception may be certain types of spondylolisthesis caused by traumatic injury.
When surgery is necessary, your spine neurosurgeon may recommend one of the following types of surgery:
- Spinal fusion surgery for spondylolisthesis permanently connects two or more vertebrae to eliminate motion, relieving the irritation on the nerve and reestablishing the normal positioning of the bones. Learn more about spinal fusion surgery.
- Laminectomy, a type of decompression surgery can relieve pain caused by spondylolisthesis and is typically done in combination with spinal fusion surgery for this condition.