Lumbar spondylolisthesis (spon-deh-lo-lis-THEE-sis) typically occurs in the lower back when one vertebra slips forward over the vertebra below it.

Many cases of spondylolisthesis stem from arthritis associated with aging. The condition can be treated with nonsurgical techniques, but sometimes surgery is required.

The lower back, or lumbar spine, starts at your lowest rib and reaches to the top of your pelvis. There are five vertebrae surrounding the spinal cord, with spongy, doughnut-shaped discs serving as cushions between the bones.

Lumbar spondylolisthesis is one of several spinal disorders that may become symptomatic at different periods in a patient’s lifetime. Some children are born with spondylolisthesis, and people of all ages are susceptible to developing the condition if it runs in the family.

Spondylolisthesis and spondylolysis are related but different conditions. Spondylolysis refers to stress fractures in the thin bones that joins vertebrae. These bones, the pars interarticularis, are at risk of injury from sports, but can occur at an age and regardless of activities.

Isthmic spondylolisthesis can result from spondylolysis as the fractured bones allow the vertebra to shift forward. This condition can result from involvement in sports such as football, cheerleading or gymnastics that cause hyperextension of the lumbar spine that can cause spondylolysis fractures over time.

Aging can cause degenerative spondylolisthesis, a condition that results from the discs between vertebrae drying and thinning, allowing a vertebra to slide over the one below it.

Read more: Woman conquers spondylolisthesis back pain with surgery

Lumbar spondylolisthesis symptoms

• Back and leg stiffness
• Chronic lower back pain
• Tenderness in the lower back
• Tight hamstring and buttock muscles
• Thigh pain

Pain and difficulty with walking doesn’t need to limit activities.

The skilled physicians at Norton Leatherman Spine have the experience to identify the right treatment for a broad range of spinal conditions, including lumbar spondylolisthesis. The combined team of orthopedic spine and neuroscience specialists at Norton Leatherman spine provides comprehensive care.

Our specialists know that surgery isn’t right for everyone. If simpler treatments don’t work, and relief will come only from an operation, you’ll want surgeons with the most experience and expertise.

Read more: Retired doctor gets back to her life: Spinal fusion recovery story

International Reputation for Excellence

Kenton D. Leatherman, M.D., pioneered new approaches to spine care after World War II. His commitment to bring the best and most innovative care to his patients provides the foundation for today’s practice. Our orthopedic and neurosurgical spine physicians combine proven treatments that have built our reputation for over 25 years with new developments at the leading edge of innovative care.

Specialists at Norton Leatherman Spine surgeons are recognized experts in the evaluation and treatment of lumbar spondylolisthesis, having published extensively on this important topic:

• Charles H. Crawford III, M.D., was the principal author for the Scoliosis Research Society systematic review “The Current Evidence on the Surgical and Nonsurgical Treatment of Pediatric Lumbar Spondylolisthesis.”
• John R. Dimar II, M.D., helped develop an innovative and widely regarded classification for spinal alignment in patients with spinal deformity secondary to lumbar spondylolisthesis.
• Steven D. Glassman, M.D., has published extensively on the treatment of lumbar spondylolisthesis, and recently served as a New England Journal of Medicine expert panel member on this topic.

We’ll evaluate your case and give you a treatment plan customized for you.

Spine Treatment that Spans Childhood to Older Age

Norton Leatherman Spine is unique in the region in providing spine care to patients of all ages. This experience allows us to better implement the full range of nonsurgical and surgical options, with a full understanding of how decisions made today may impact a patient’s function and quality of life in the future.

The first approach to treating spondylolisthesis is nonsurgical therapy to ease pain and help the bone move back into place.

Nonsurgical treatments may include:

• Bracing
• Cold/heat therapy
• Nonsteroidal anti-inflammatory medication
• Physical therapy and occupational therapy
• Mental health therapy to help you cope with your condition
• Injections to reduce swelling around a nerve

Surgery is considered for patients who have not gotten relief or whose symptoms have worsened.

Surgical options, including removal of the cause of your spondylolisthesis, can ease pressure on the nerves and help relieve pain. Minimally invasive surgery is often an option for this procedure.

Surgical fusion to stabilize the spine, which can be performed as a minimally invasive procedure, may be an option to reduce pain and restore function.

Lumbar Spondylolisthesis in Children and Adolescents

Some degree of spondylolisthesis is common in children and most often is treated with temporary activity restriction or bracing. If surgery is required, Norton Leatherman Spine surgeons have the experience to know whether a limited procedure to repair the bony defect (pars repair) will be sufficient, or whether a more extensive correction of alignment is necessary.

Midline Lumbar Interbody Fusion (MidLIF)

In older patients, the need for surgical treatment usually is related to associated spinal stenosis causing leg pain and difficultly walking. Recent studies have questioned the extent of surgery necessary to treat this problem effectively. Norton Leatherman Spine is one of the leading centers in a nationwide study designed to inform this decision. When fusion is necessary, Norton Leatherman Spine surgeons have long experience with innovative, minimally invasive techniques, such as midline lumbar interbody fusion (MidLIF), that provide high quality outcomes and can facilitate more rapid recovery.

About Norton Leatherman Spine

Norton Leatherman Spine is a combined team of orthopedic spine surgeons, neurosurgeons from Norton Neuroscience Institute and pain management specialists who provide care for adults and children from Louisville and Southern Indiana, as well as from across the region, nation and world.

• The multidisciplinary team incorporates expertise from a variety of specialties to offer a comprehensive array of treatment options that include minimally invasive and nonsurgical therapies.
• Our team approach to the diagnosis, treatment and rehabilitation of spine conditions works cooperatively with primary care physicians and other specialists to develop a treatment plan as unique as each individual.
• Because you may not need surgery, you may work with our pain management team, physical therapy specialists and others who can create a care plan with the right types of treatments for you.
• If you need surgery, you’re in experienced hands. Norton Leatherman Spine physicians perform more than 4,000 surgeries a year.
• Our team has more than 45 specialists at nearly 20 offices across Louisville and Southern Indiana. Many offer same-day appointments and Saturday hours, with no referral needed
• Our specialists are internationally recognized leaders in clinical research of spinal disease, injury and deformity, and have served in senior positions in the Scoliosis Research Society, the most prestigious organization for scoliosis surgeons around the world.
• Norton Healthcare is the first health system in the nation to be recognized as an Advanced Orthopedic & Spine Center of Excellence by DNV.
• We offer minimally invasive and robotic-assisted procedures that carry less risk and can speed your recovery.
• We use the EOS Imaging system, which collects high-resolution images while exposing the patient to 50% to 85% less radiation than traditional X-rays and 95% less than basic CT scans. The system is especially beneficial to scoliosis patients who often need repeated imaging to monitor their progress.
• Use MyNortonChart to communicate with your provider, manage appointments, refill prescriptions and more, anytime from a mobile device or computer