Spondylolisthesis: Slipped Vertebra Symptoms, Diagnosis & Treatment

Spondylolisthesis is a condition that occurs when the bones of the spine, or vertebrae, "slip" and shift in position relative to one another (1). Though this condition is most common in older individuals with aging and gradual wear and tear of the spine, younger individuals, particularly those who participate in sports requiring frequent hyperextension of the back (e.g., gymnastics) are also at risk (2). This article discusses the symptoms associated with spondylolisthesis, how the condition is diagnosed, and treatment options available to help.

Most cases of spondylolisthesis are asymptomatic and discovered incidentally on imaging completed for other concerns. When patients do display symptoms, they most often report back pain that may be accompanied by shooting pains down the arm or leg (1,2).

Patients with degenerative (age-related) spondylolisthesis often report signs of neurogenic claudication (3), including:

• Pain in the buttocks or legs
• Pain worsens with standing or walking
• Pain is relieved by bending the spine or sitting down

Conservative management is recommended as first-line treatment for spondylolisthesis, which can include:

• Physical therapy building strength in spine flexion
• Activity modification
• NSAIDs (Ibuprofen [Advil™], Naproxen [Aleve™]) for pain relief
• Steroid injections

While the majority of patients with spondylolisthesis improve without the need for surgery, some patients may have persistent or worsening symptoms despite using conservative management strategies. In these patients (and those with evidence of neurologic compromise), surgical decompression of the spine is considered.

Spinal decompression can be performed with and without vertebral fusion, or the attachment of the slipped bones in question to prevent further instability and slippage.