Spondylolisthesis

When a Backbone Slips Forward Onto the Backbone Beneath It, Causing Low Back Pain and Leg Pain

Facts and Information

Although a diagnosis of spondylolisthesis (pronounced “spon-dl-oh-lis-THEE-sis) might sound intimidating, it is not necessarily a cause for concern. Despite the long name, this is a common condition that affects over three million Americans each year.

Spondylolistheis is often diagnosed in people who are born with a defect of the backbones. Additionally, like many other back problems, spondylolisthesis may appear as the spine wears down with age or repeated injuries. Although spondylolisthesis does not go away on its own, the pain can improve with medications, physical therapy, and treatments from a pain specialist.

Some facts about spondylolisthesis:

• It is most common in the low back (lumbar spine) area.
• It is most likely to appear after the age of 50 in both men and women, with women having a higher risk than men.
• The ratio of female to male patients who develop this condition is 1.3 to 1 (13 women for every 10 men).

How Spondylolisthesis Starts

Spondylolisthesis involves an abnormal shift in the backbones — the spine's building blocks that support the body and hold it upright. The backbones are stacked one on top of the other throughout the length of the spine. Between a backbone and the one above there is a cartilage disc and small joints that absorb shocks when a person moves.

• For younger patients (under 50 years of age) spondylolisthesisstarts due to a birth defect that affects the backbones. This is known as a pars intrarticularis defect. People with this defect have a fracture (break) in the back part of a backbone, usually in the lower back. Their backbones start to shift out of place and eventually cause low back pain. A pars defect may not cause pain, initially. However, in time, it may start to cause low back pain.
• A common cause for spondylolisthesis for patients over 50 years of ageis a gradual wear-and-tear of the discs, joints, and other structures in the back. Your pain specialist may refer to this as “degenerative changes in the spine”. People with this type of spondylolisthesis have low back pain due to worn-out discs (Degenerative Disc Disease), pseudoarthrosis (a painful bone-on-bone rubbing between two backbones), or irritated nerves (Lumbar Radiculopathy).