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Dr. Anthony Virella, MD, FACS
Board-Certified Neurological Spine Surgeon



What is Spondylolisthesis and How Is It Treated?



What is Spondylolisthesis and How Is It Treated?


The lumbar or lower back region of the spine is composed of five vertebrae (L1-L5). The vertebrae are responsible for absorbing and distributing the majority of the body’s weight. When one the lumbar vertebra slips forward (anteriorly), a condition known as spondylolisthesis is said to be present. Neurosurgeons classify this using an increasing severity scale of Grade 1– Grade 5.

Symptoms of Spondylolisthesis


Mild cases of spondylolisthesis may cause little to no symptoms. Moderate to severe cases may cause any or any combination of the following:
  • Lower back pain
  • Pain in the buttocks
  • Difficulty walking
  • Tightness in the hamstring muscles
  • Postural abnormalities (an arched lower back and a protruding abdomen)
Identifying the cause is an important diagnostic and treatment step.

Causes of Spondylolisthesis


Spondylolisthesis is caused by the following:
  1. A birth defect. Some patients are born with the condition.
  2. A fracture. A fracture can cause a vertebra to weaken and slip forward.
  3. Degenerative disc disease. A disease characterized by the wear and tear of vertebral bones and soft tissues with age.
Degenerative disc disease is the most common cause of spondylolisthesis. Diagnosing degenerative disc disease and spondylolisthesis in their early stages allows neurosurgeons to treat the conditions and decrease symptoms quickly.

Diagnosis of Spondylolisthesis

X-rays taken from multiple angles allow neurosurgeons to visually confirm and determine the severity. The following previously mentioned scale is used to classify the condition based on the degree the vertebra has slipped:
  1. Grade 1 (G1). 24% or less
  2. Grade 2 (G2). 25%-49%
  3. Grade 3 (G3). 50%-74%
  4. Grade 4 (G4). 75%-99%
  5. Grade 5 (G5). Complete
Once spondylolisthesis is properly classified, an effective treatment plan can be prescribed.

Treatments for Spondylolisthesis


Nonsurgical treatment is very effective. Some of the most common nonsurgical treatment options include the following:
  1. Rest and ice. Slowing down or stopping activities and applying ice to painful areas decreases pain and inflammation.
  2. Nonsteroidal anti-inflammatory medications (NSAIDs). Over-the-counter and prescription medications that decrease pain and inflammation.
  3. Physical therapy. Exercises that help stretch and strengthen the muscles, ligaments, and tendons of the lower back.
  4. Epidural steroid injections. A fast acting temporary pain relief treatment solution.
Surgical intervention may be necessary to treat severe cases of spondylolisthesis or cases that do not respond to nonsurgical treatment options. There are several minimally invasive spinal procedures that are performed to realign the vertebrae.

Seeking Treatment for Spondylolisthesis


If you are experiencing chronic back pain and are looking for a pain relief solution, it can be found when you contact one of our 3 Southern California offices. We will find out what is causing your pain and then come up with a personalized treatment plan. You can expect results when you choose our clinic.




Dr. Anthony Virella is a Board-Certified, Fellowship trained Neurological Spine Surgeon with advanced training in the management of complex spinal disorders. He attended medical school at Columbia University College of Physicians and Surgeons and is a graduate of the UCLA Neurosurgery Residency Program. Dr. Virella is a nationally recognized specialist in the field of complex and Minimally Invasive Spine Surgery and has offices located in Agoura Hills, Valencia and Palmdale. If you, or someone you love, is suffering from persistent neck or back pain, contact us today to schedule an appointment.

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