1. Spondylolisthesis Treatment – Finding a Regimen that Works Best for You
Spondylolisthesis treatment can vary greatly from patient to patient, depending on the severity of the
spinal condition and what has caused it. The condition, which occurs when one vertebra slips over the
vertebra beneath it, typically occurs as a result of the natural aging process. As we grow older, our
spines begin to deteriorate from continually supporting the body’s weight and years of flexible
movement. This can lead to a number of degenerative spine conditions, including degenerative disc
disease, which is the deterioration of the intervertebral discs. When the discs deteriorate, they are
prone to herniating or bulging and can cause the vertebrae to shift out of place. Degenerative disc
disease is one of the leading causes of spondylolisthesis.
Grades & Symptoms of Spondylolisthesis
When you are diagnosed with spondylolisthesis, your doctor will determine which grade of
spondylolisthesis you have. The grade indicates the degree to which the affected vertebra is misaligned:
• Grade 1 – Up to 25 percent slippage
• Grade 2 – 26 to 50 percent slippage
• Grade 3 – 51 to 75 percent slippage
• Grade 4 – 76 to 100 percent slippage
If you have low-grade spondylolisthesis (less than 50
percent slippage), you may not experience any
symptoms at all, and the condition may remain
undiagnosed. If you do have any spondylolisthesis-
related symptoms, they may include pain,
tenderness, muscle spasms, and stiffness. As a
general rule, the grade of your spondylolisthesis will
increase in conjunction with the severity of your
symptoms.
If the misaligned vertebra comes into contact with a
spinal nerve or the spinal cord, you may experience
neuralgia, which is pain, muscle weakness, tingling, and numbness that travels along the length of a
nerve. The location of your symptoms will vary depending on which region of the spine is affected:
• Cervical spine (neck) – Nerve compression in the cervical spine can cause discomfort in the neck,
upper back, shoulders, and/or arms.
• Thoracic spine (middle back) – If a nerve in your thoracic spine is compressed, symptoms may
appear in the middle back, ribs, torso, or internal organs.
• Lumbar spine (lower back) – If your lumbar spine is affected by spondylolisthesis, you may
experience symptoms in the lower back, hips, buttocks, and/or legs. If the misaligned vertebra is
in contact with the sciatic nerve you may experience sciatica, typically along one side of the
body. Spondylolisthesis most commonly occurs in the lumbar spine.

2. Conservative Treatments
Spondylolisthesis treatment typically entails any number of conservative, noninvasive treatments,
especially if the condition is considered low grade. Medications, such as over-the-counter, non-steroidal
anti-inflammatory drugs (NSAIDs), pain relievers, or muscle relaxants may be prescribed to alleviate
your pain-related symptoms. Your doctor may also recommend that you attend physical therapy
sessions, where a therapist will work with you to strengthen the muscles surrounding the spine. Physical
therapy may also entail transcutaneous electrical nerve stimulation (TENS), hot/cold therapy, and
posture modification exercises. Your doctor may also recommend that you avoid strenuous activities
that can contribute to your spondylolisthesis-related symptoms and may suggest intermittent periods of
rest.
Alternative Therapies
Doctor-prescribed spondylolisthesis treatment can often be complemented with holistic, alternative
therapies. Some of the popular alternative therapies for this spinal condition include:
• Acupuncture – Acupuncture is performed by inserting small needles into very specific points on
the body. This type of treatment may help to promote healing and relieve pain by increasing the
body’s production of endorphins.
• Restorative yoga – Yoga is a type of exercise that utilizes
stretching techniques and held poses to increase the strength and
flexibility throughout the body. This can benefit patients with
spondylolisthesis in that stronger back muscles can better
support the spine, thereby relieving some of the pressure that is
being placed on a spinal nerve.
• Herbal supplements – Some nutritional supplements, vitamins,
and herbs are said to reduce pain and inflammation. If you are
interested in taking herbal supplements for spondylolisthesis, consult an herbal nutritionist to
find the supplements that will provide you with optimal results.
It is important to note that the medical community has yet to come to a consensus regarding the
efficacy of many types of alternative therapy. A number of patients, however, regard alternative therapy
methods as the source for their relief. If you choose to complement your doctor-prescribed
spondylolisthesis treatments, be sure to let your doctor know. He or she may alter your treatment plan
to prevent complications from arising, such as an interaction between an herbal supplement and a pain
medication.
Surgical Treatment for Spondylolisthesis
If you are unable to relieve your spondylolisthesis symptoms through noninvasive means, your doctor
may recommend surgery. The majority of patients with spondylolisthesis will not require surgical
treatment but, for those who do, a number of factors should be considered before consenting to an
operation. Among these factors are the risks and benefits that are associated with the different types of
surgical procedures that are available for the treatment of spondylolisthesis, including spinal fusion and
minimally invasive procedures.

3. Spinal Fusion
A spinal fusion is performed under general anesthesia and requires a sizeable surgical incision. During
the operation the affected vertebra, or the portion of the vertebra that is compressing the spinal nerve
or the spinal cord, is removed. To compensate for the
removal of a portion of the spinal anatomy, adjacent
vertebrae are then fused together, which is typically
accomplished with a bone graft and stabilizing
hardware. This region of the spine is then restricted
from moving, which is one of the downsides to spinal
fusion surgery. Many patients face a lengthy hospital
stay and arduous recovery, factors which deter some
patients from undergoing the procedure altogether.
Patients also face the risk of developing an infection as
well as failed back surgery syndrome (FBSS), or the
continuation or worsening of symptoms following open
spine surgery. The body may also reject the bone graft
and/or stabilizing hardware, requiring the operation to
be re-performed.
Minimally Invasive Procedures
Some patients may choose to undergo a minimally invasive procedure in lieu of open spine surgery.
Performed on an outpatient basis, minimally invasive spondylolisthesis procedures are performed
through a very small incision and utilize an endoscope. Unlike with open spine surgery, only the portion
of the spinal anatomy that is compressing a spinal nerve is removed, preventing the need for spinal
fusion. As such, patients face a much shorter recovery and many are able to return to daily activities
within two weeks.
Weighing the Risks and Benefits
Each type of surgical spondylolisthesis treatment comes with its own unique risks and benefits. If you’re
unsure of which type of surgery is best for you, be sure to talk the decision over with your doctor. You
may also want to pursue a second or third opinion to ensure surgical treatment for your condition is
even warranted.