Spondylolithesis is a condition in the spine where one vertebral body has slid forward or backward in relation to another.  It is most common in the lumbar area.

As people age, the likeliness of spondylolithesis increases.  The presence of spondylolithesis is not necessarily a problem, however it may lead to the spinal cord or nerve roots being compressed.  The compression of the spine or nerve roots is often gradual, and sometimes leads to numbness, weakness, and pain especially in the legs.  The slippage can also appear without any symptoms; therefore its presence does not necessarily mean that a problem exists. Even very significant spondylolithesis can be present with no or minimal symptoms and can be managed by very minor levels of treatment.

Causes of Spondylolithesis

The slippage in the spine is caused by problems in the posterior elements of the spine – the facets and connecting bony structures.  When these joints are not functioning correctly, slippage can occur.  Joint damage can occur from:

• Birth defects
• Physical damage by trauma or stress fractures
• Arthritis

Spinal slippage can also result from sports injuries and arthritis as people age.

Diagnosis & Treatment

Spondylolithesis can be easily diagnosed with plain X-rays.  Again, the presence of the slippage does not necessarily mean that there needs to be any special treatment.  Many people are completely without symptoms.  However, if painful symptoms do exist, there are several options for treatment.

Treatment starts with using proper body mechanics for movement, and maintaining core muscle strength.  Seeing a physical therapist may help learning the right strengthening and stretching.  If spondylolithesis is irritating nerves, more intense physical therapy may be necessary, and working with a pain physician may be beneficial.  Chiropractic manipulation of the slippage is not advisable.  If significant weakness occurs or bowel and bladder control is lost, then surgical intervention may be necessary.