Spondylolisthesis Health Article

Definition

Spondylolisthesis is a condition in which a bone (vertebra) in the lower part of the spine slips forward and onto a bone below it.

Causes, incidence, and risk factors

In children, spondylolisthesis usually occurs between the fifth bone in the lower back (lumbar vertebra) and the first bone in the sacrum area. It is often due to a birth defect in that area of the spine.

In adults, the most common cause is degenerative disease (such as arthritis). The slip usually occurs between the fourth and fifth lumbar vertebrae.

Other causes of spondylolisthesis include stress fractures (commonly seen in gymnasts) and traumatic fractures. Spondylolisthesis may occasionally be associated with bone diseases.

Symptoms

Spondylolisthesis may vary from mild to severe. A person with spondylolisthesis may have no symptoms.

The condition can produce increased lordosis (swayback), but in later stages may result in kyphosis (roundback) as the upper spine falls off the lower spine.

Symptoms may include:

• Lower back pain
• Muscle tightness (tight hamstring muscle)
• Pain in the thighs and buttocks
• Stiffness
• Tenderness in the area of the slipped disc

Nerve damage (leg weakness or changes in sensation) may result from pressure on nerve roots and may cause pain radiating down the legs.

Signs and tests

The doctor will perform a physical exam. A straight leg raise may be uncomfortable or painful.

X-ray of the spine can show if a vertebra is out of place, and whether there are any fractures.