Spondylolisthesis: Is It Causing Your Back and Leg Pain?

What causes spondylolisthesis?

There are several different types of spondylolisthesis, and the cause of the condition may be related to the type. While spondylolisthesis occurs more frequently in older adults as the result of wear and tear, spondylolisthesis resulting from trauma is one of the more common causes of back pain in adolescents.

Overall, some of the most common risk factors include:

• Overuse and wear and tear on the affected joint
• Frequent, improper movements or lifting
• Osteoarthritis
• Degenerative disc disease
• Obesity
• Inactivity
• Malnutrition
• Smoking and excessive alcohol consumption
• Sudden injuries resulting from manual labor, high-impact sports, or falls
• Bone abnormalities present at birth

What are symptoms of spondylolisthesis?

There are some people who have spondylolisthesis and experience no symptoms. Among those who do, symptoms can be extremely varied.

Some of the most common symptoms include:

• Chronic low back pain or neck pain
• Leg/arm pain
• Pain, numbness, and weakness in the calves, buttocks, and/or thighs, often caused by standing or walking for long periods
• Pain that is relieved with sitting, especially in a reclining position
• Fatigue in the legs/arms
• In adolescents, spondylolisthesis resulting from high-impact trauma may cause a noticeable curve or sway in the lower back

Are nonsurgical treatments available for spondylolisthesis?

Spondylolisthesis typically is first treated with noninvasive therapies, including:

• Ice. Cold packs or ice applied to the area may reduce inflammation and relieve pain.
• Steroid injections. A steroid injection can provide temporary pain relief.
• Physical therapy. Your physician may suggest physical therapy, possibly along with pain-relieving steroid injections so you can do exercises with minimal discomfort.
• Pain medications. Over-the-counter pain relievers, such as acetaminophen (Tylenol), and nonsteroidal anti-inflammatory medicines, such as ibuprofen or aspirin, may be useful for chronic pain. Prescription pain relievers may be necessary during episodes of extreme pain but are not recommended for long-term relief.

What surgical options are available for spondylolisthesis?

At Neurosurgery One, our Denver area spine neurosurgeons generally recommend spine surgery for less severe cases of spondylolisthesis if the condition causes pain that is not adequately relieved by more conservative treatments after six to 12 months. For patients with a grade 3 spondylolisthesis (50 to 75 percent slippage) or grade 4 (more than 75 percent), if conservative treatments are not working after three to six months, surgery may be the best option. One exception may be certain types of spondylolisthesis caused by traumatic injury.

When surgery is necessary, your spine neurosurgeon may recommend one of the following types of surgery:

• Spine fusion surgery for spondylolisthesis permanently connects two or more vertebrae to eliminate motion, relieving the irritation on the nerve and reestablishing the normal positioning of the bones. Learn more about spine fusion surgery.
• Laminectomy, a type of decompression surgery can relieve pain caused by spondylolisthesis. For this condition, surgeons typically perform it in combination with spine fusion surgery.