Overview
Spondylolisthesis means one vertebra has slipped forward relative to the one below it, most often in the lower back. In adults, the most common type is degenerative spondylolisthesis, caused by arthritis of the facet joints and disc wear. Another type, isthmic spondylolisthesis, comes from a small stress fracture (spondylolysis) in the back of the vertebra.
A slip can narrow the space for nerves (stenosis) and may cause back pain, leg pain or both. Many people do well without surgery.
Watch and learn
Video: “Spine Talks – Spondylolisthesis, Episode 1” from Mayo Clinic on YouTube. It loads from youtube-nocookie.com only when you press play. Shown for general education; GSMC did not produce it. Watch on YouTube
Captions: press the CC button in the video player to turn on captions. Some captions are generated automatically by YouTube and may contain errors.
Symptoms
- Low back pain, often worse with standing or bending backward
- Leg pain, numbness or heaviness with walking that eases with sitting or leaning forward
- Tight hamstrings
- Less commonly, weakness in the legs
Causes
- Facet joint arthritis and disc degeneration (degenerative type, more common after age 50)
- Stress fracture of the pars interarticularis (isthmic type)
- Congenital differences
- Trauma, tumor or prior surgery (less common)
How it is diagnosed
Standing X-rays, including flexion and extension views, show how much the vertebra has slipped and whether it moves. MRI shows nerve compression and disc health.
Treatment options, step by step
A spine surgeon looks at the whole picture, including options short of surgery. Not every step applies to every person.
Self-care and lifestyle
Core strengthening, walking and avoiding repeated heavy back-bending may help.
Physical therapy and medications
Physical therapy with a stabilization program, and medicines if safe for you.
Injections and nerve blocks
Epidural steroid injections for leg pain, or facet injections for back pain.
Minimally invasive procedures
For stenosis with a stable slip, some minimally invasive options may be considered in selected cases.
Surgical evaluation
Decompression with fusion is considered for ongoing leg pain, neurological symptoms or instability.
Nonsurgical alternatives
Many spine problems are managed without surgery. See our nonsurgical options and holistic and lifestyle care guides.
Related surgeries
Call 732-202-3000 to confirm which surgeon performs this procedure and where.
When to seek urgent care
Call 911 or go to the emergency department for new or rapidly worsening weakness, numbness in the groin or inner thighs, loss of bladder or bowel control, or severe pain after a fall or accident.
Frequently asked questions
Will the slip get worse?
Degenerative slips usually progress slowly, if at all. Your surgeon may repeat X-rays to check.
Do I need a fusion?
Not necessarily. Fusion is considered when symptoms continue despite other care, or when imaging shows instability.
Can I exercise?
Yes. Core and hip strengthening and walking are usually encouraged. Ask your clinician which movements to limit.
This page is general patient education and does not replace advice from your own clinician. Individual results vary.