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In plain language, spondylolisthesis means the abnormal forward placement of a vertebral body in relationship to another vertebral body.  It is more than a “slip of a disk”.

To understand the finding,  we must first understand the normal orientation of the vertebral bodies to each other,  and the nature of the structures of the spine.

The spine has a function of providing structure,  flexibility,  and protection of the nerves that come out from the brain into the body.

Nerves carry communication from the brain to the various organs,  ligament and muscles of the body.  In addition,  the nerves carry information to tell the brain if the coordination of the various body parts are achieving the intended action,  and also protects the body from any harmful insult.

The spine is a collections of functions spine units (FSU),  which comprises of two vertebrae,  connected together by a disc, two facet joints in the back,  and the associated ligaments that hold the facet joints,  and the vertebra together.  The FSU also protects the nerve tissues that occupy the center of the spine unit,  and protects the nerves as the exit out the holes of the FSU (foramen).

In spondylolisthesis,  the FSU no longer functions normally,  and the vertebral bodies are no longer oriented  in alignment.  To make that concept easier,  if you place two same sized rings on top of each other,  that would be the normal orientation.  When you look a the rings through the top or bottom opening,  you will see a round circle.  You can easily see an object passing through the center of the two rings,  and the space would be uniform.

In this example,  to demonstrate a spondylolisthesis,  have one ring placed out of alignment to the other ring,  therefore causing the opening hole now narrower in size.  The once circular hole is not more oblong.  If you further displace the rings from each other,  that oblong space will become narrower and smaller.  That is the analogy of spondylolisthesis.  The vertebra,  in the back, consists of a ring that allows the spinal cord or nerves pass through the center.  If the vertebral rings shift,  that is spondylolisthesis.

Spondylolisthesis can be caused by ligament laxity, or stretching that allows the vertebral ring to shift forward of each other.  That usually requires an incompetent disc,  and the ligaments associated with the capsules of the facet joints and the various interspinous ligaments.

Spondylolisthesis can be caused by  a fracture of the back of the vertebra in the area of the pars intraarticularis,  causing extra stress to the disc and ligaments,  resulting in the shifting of the vertebral rings on one another.

Spondylolisthesis can the result of a congenital development,  a degenerative development,  or a traumatic event.

Last modified: December 11, 2019

38 thoughts on “Spondylolisthesis

  1. I saw Dr. Shim when I was 12 years old after severe back pain. He diagnosed me with spondylolisthesis. I guess I was born with it, but since I was such an active child, it never got a chance to properly heal. He put me in a brace for about 6-9 months and I was good to go! I still have pain from time-to-time but I just have to remind myself to take it easy and it will go away. Thanks Dr. Shim!

  2. I had 2 fusions done, one 1993 and one in 1997 due to a failed fusion. I had a secondary spondolothesis with a lot of of instability. Some doctors thought due to congenital other doctors thought due to me being hit by a car at 5 years, when I also had a broken femur with traction and then a body cast. Both surgeries did not help at all. The second surgery I had screws and plates and a bone growth stimulater. I still have all hardware and am having burning pain near hardware. I’ve had the hardware and stimulater and wires for over 23 years could I have these removed? Or should they remain because of instability? They are in L4 L5 and S1 . Is burning near the site a common symptom of loosining of screws or hardware failure or mettalosis? Thank you

    1. Janet, I hope you have a doctor that can evaluate you and help you with your answers. Hardware removal can help if there are issues related to the hardware. On the other hand, if you are not adequately fused, and there are other concerns, you may need more than just a hardware removal. Please get evaluated by someone who can examine you, review all your prior images, and suggest a plan. A thoughtful discussion on the risks, benefits, and alternatives to your options must also be explored. It can be hard to stay positive considering your circumstances, but do not give up doing the things that will make you better, stronger and more functional.

  3. Dear sir, i have cervical spondylosis. Recent MRI report is C2-C3 13mm, C3-C4 11mm, C4-C5 9.8mm, C5-C6 9.5mm, C6-C7 9mm, C7-D1 10mm. C5 c6 and c6 c7 are bulged and had inflammation. That discs are pinching nerve root. sometimes I feel radiating pain and numbness in left hand. One year back numbness was in right hand. Neck pain is less and sometimes tolerable pain. Is ithere any remedy for permanent cure?

    1. There is no permanent cure and it sounds like every level in your neck is affected. A good exercise program (set up by a physical therapist) and treatment of symptoms as they happen is most common. Diet, no smoking and avoiding strenuous activity will also help.

    1. Spondylosis is the build-up of bone spurs and the wear and tear on the spine (like arthritis in the Joints). Spondolysthesis is the slipping of one level of spine over the other.

  4. Plz suggest remedies to overcome the problem. I hv lumber back pain. And there is gap between L4 & L5 in my disc. Plz suggest me what is remedy.

    1. We do not provide opinions or a diagnosis on patients we have not personally examined. Please see your primary physician to get names of reputable spine physicians you can see.

    1. Please look at some of the videos and blogs on this website. We are strong proponents of prevention, exercise, stretching and learning how to do all of this correctly to prevent injury. A strong core will be your most valuable asset.

  5. I have been to 4 doctor 1 orthopedic and 3 neurosurgeon the doctor said I had spondyloisthesis is there a exercise that I can do to help with for pain.

    1. Hi Barbara, Get one of these physicians to recommend a Physical Therapy group that does a lot of spine work. Movement is your ally. Please check out the exercises provided on the website and download the app. They really work!

    1. Please discuss this with your physician and physical therapist. AS is a chronic disease and should be managed as such.

    1. I’m sorry. We do not provide opinions or a diagnosis on patients we have not personally examined. Please see your primary physician to get names of reputable spine physicians you can see.

    2. We do not provide opinions or a diagnosis on patients we have not personally examined. Please see your primary physician to get names of reputable spine physicians you can see.

  6. I have a chronic lumbar strain. i had 10 sessions of theraphy. As of now I’m wearing back support. All I want to know if this will be back again in normal position and how long? I’m 53 yrs. old. and I’m a teacher. is there a medication for me to take just to bring back in normal position?

    1. We do not make any recommendations, beyond the blogs and video’s, without actually seeing the patient. Please note that exercise will help much more than a brace.

    1. Physical therapy is always a good option as a starting point. They will teach you body mechanics and what to avoid as you are getting better.

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