Spondylolisthesis

Overview

Spondylolisthesis is a forward slip of one vertebra over another, most often in the lower lumbar spine. It can be due to a stress fracture in younger athletes or degenerative change in older adults. Many cases are managed well with strengthening and activity modification.

Symptoms

• Lower back pain, often worse with extension
• Stiffness and fatigue with standing or walking
• Sometimes leg symptoms if nerves are crowded
• A sense of instability in the back

Causes

• Stress fracture of the pars (younger athletes)
• Degenerative change in the facet joints (older adults)
• Repetitive extension loading

Treatment

• Core and hip strengthening
• Activity modification and load management
• Avoiding repeated end-range extension early on
• Surgical opinion for significant slips or nerve compromise