What Is Spondylolisthesis?
Spondylolisthesis is vertebral slippage, most commonly in the lower back. The old site highlighted isthmic and degenerative types. PPSI evaluates whether the slip is stable, whether nerves are compressed, and whether pain is coming from the disc, joints, muscles, or nerve roots.
Common Types and Causes
- Isthmic: Often related to a pars stress fracture, sometimes beginning in adolescence or sports.
- Degenerative: Arthritis and disc wear allow gradual slippage in adults.
- Traumatic or pathologic: Less common, related to injury, bone disease, tumor, or surgery.
Symptoms
Symptoms may include low-back pain, tight hamstrings, buttock pain, sciatica, numbness, weakness, pain with standing or extension, or relief when sitting. Red flags include progressive weakness, foot drop, bowel or bladder changes, saddle numbness, fever, trauma, or cancer history.
Diagnosis
X-rays can show the slip and whether it changes with flexion and extension. MRI evaluates discs, nerves, and stenosis. CT may be useful for pars defects or surgical planning. PPSI also performs a neurologic exam and functional assessment to determine how the slip affects movement and daily activity.
Treatment Options
Many patients start with physical therapy focused on core stabilization, hip mobility, neutral-spine mechanics, and safe activity progression. Medication guidance and bracing may help selected cases. If nerve inflammation is prominent, image-guided epidural injections or selective nerve-root blocks may help. Surgery may be considered for instability, progressive neurologic symptoms, severe stenosis, or persistent disabling pain.
PPSI Care Path
We explain the grade of slip, whether it is stable, and what symptoms match imaging. That clarity helps patients avoid both under-treatment and premature surgery.
Frequently Asked Questions
Is spondylolisthesis the same as a slipped disc?
No. Spondylolisthesis is a slipped vertebra; a slipped or herniated disc is a disc problem. They can occur together.
Can I exercise with it?
Often yes, but exercise should be guided. Extension-heavy movements may aggravate symptoms in some patients.
Will it require fusion?
Only selected cases need fusion. Many patients improve with non-surgical care and targeted injections.