Spondylolisthesis is a medical term used for describing vertebral slippage in the spinal column. The human spine has a perfectly aligned S shape, but spondylolisthesis distorts this alignment. With spondylolisthesis, a vertebra slips forward or backward onto the vertebra below.
Depending on the cause, spondylolisthesis can be classified into 5 different types: degenerative, isthmic, dysplastic/congenital, pathogenic, and traumatic spondylolisthesis.
Most commonly caused by degenerative diseases. It’s usually found in older people and is especially common among African-Americans.
Affects both adults and children. It is generally caused by a small fracture(s) in the pars interarticularis, part of the facet joint.
Also known as congenital spondylolisthesis, is a result of a congenital birth defect.
This form of spondylolisthesis is caused by diseases such as tumors or infections.
The result of a bone fracture from a traumatic event.
Although vertebral slippage from spondylolisthesis can occur anywhere on the spine, it is most common in the lower back and is a major source of lower back pain. Even though in many cases, spondylolisthesis symptoms can be improved with non-surgical treatments, although serious spondylolisthesis may need surgery.
The severity of spondylolisthesis is measured by the degree of slippage, or the percentage of one vertebral body that has slipped forward on another. The higher the spondylolisthesis grade, the more severe the condition is. Each of the four spondylolisthesis grades represents a 25% slippage.
Note From Dr. Liu
Spondylolisthesis grades dictate the proper course of treatment. Grade 1 and 2 spondylolisthesis are generally responsive to conservative treatments, but higher grades often require surgery
Figure 1a. A healthy spine with no vertebral slippage.
Figure 1b. Spondylolisthesis seen in an unhealthy spine.