Spondylolisthesis

Overview, Causes, & Risk Factors

The spine is divided into 5 anatomical sections: cervical (neck), thoracic (thorax or rib cage), lumbar (the lower back from bottom of the thoracic spine to the top of pelvis), sacral (pelvis) and coccygeal (tail).

Spondylolisthesis is a condition in which a vertebra slips forward on the vertebra below it. In children this normally occurs between the fifth lumbar vertebra and the first sacral vertebra and is often due to a congenital malformation of that region of the spine.

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

Other causes of spondylolisthesis include stress fractures (caused by repetitive hyper-extension of the back, commonly seen in gymnasts), and traumatic fractures. Spondylolisthesis may occasionally be associated with bone diseases.

Spondylolisthesis may vary from mild to severe. It is associated with and can produce increased lordosis (abnormal convexity of the spine or 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 and pain in the thighs and buttocks, stiffness, muscle tightness, and tenderness in the slipped area. Neurologic damage (leg weakness or changes in sensation) may result from pressure on nerve roots and may cause pain radiating down the legs.