1. Spondylolisthesis Treatment
The type of spondylolisthesis treatment that is recommended to a patient will
depend entirely on the severity of the condition. For those suffering from a low
grade version of the condition, a regimen of conservative, nonsurgical treatments
may provide sufficient pain relief, while individuals who have advanced
spondylolisthesis or are at risk for spinal instability typically choose to undergo
spinal fusion surgery to permanently immobilize the affected region of the spine.
Since there are so many factors that can go into a spondylolisthesis diagnosis, including the extent of the
spinal misalignment, the symptoms that the condition has caused, the patient’s overall health, and the
location of the problem, a doctor must monitor a patient’s treatment plan closely to ensure that the
recommended methods do not make matters worse.
A Quick Overview of Spondylolisthesis
Spondylolisthesis is a degenerative spine condition that results in the misalignment of one vertebra in
relation to the rest of the spinal column. This condition can occur at any level of the spine, but is most
commonly experienced in the lumbar (lower back) region at fourth or fifth lumbar vertebral level.
Spondylolisthesis in the neck can happen in limited instances, but is usually the direct result of a
traumatic injury (often called a hangman’s fracture). The condition is rare within the thoracic (middle
back) region of the spine, because this segment is greatly stabilized by the ribcage.
When spondylolisthesis occurs, a vertebra will slide out of its normal position either laterally or
anteriorly to come to rest on the vertebra located directly below it. This slippage may be a result of
damage to part of the vertebra or the spinal column, but is most commonly traced to the natural
degeneration of one or more of the anatomical elements of the spine that normally support the lower
back.
Over time, the spinal column begins to deteriorate as a result of years of wear and tear. This is an
entirely normal part of aging and cannot be avoided. As an individual ages, the intervertebral discs that
cushion and separate the vertebrae begin to weaken and thin, which can cause them to bulge beyond
their normal boundary or even rupture. The vertebral joints that connect and stabilize adjacent
vertebrae become arthritic as the cartilage that coats the joints wears away. Ligaments calcify and
muscles weaken. A number of other degenerative changes also occur. The problem is that these
degenerative changes have a habit of snowballing and an issue with one part of the spinal anatomy can
lead to problems with another. A herniated disc, for example, can result in a loss of disc height, which
places additional pressure on the facet joints, causing accelerated joint deterioration and an increased
likelihood for vertebral slippage.
The important thing to understand about spondylolisthesis, however, is that this condition does not
necessarily have to be quite as serious as it sounds. In fact, in some instances, a patient may not have
any idea they have spondylolisthesis and will not experience any obvious symptoms of the vertebral
misalignment. Spondylolisthesis is actually described in grades of severity which explain the extent of
the vertebral slippage:

2. Grade I – 0 to 25 percent slippage
Grade II – 26 to 50 percent slippage
Grade III – 51 to 75 percent slippage
Grade IV – 76 to 100 percent slippage
Grade V – vertebral dislocation
With low grade spondylolisthesis (I & II), the condition is often only outwardly symptomatic when the
vertebral misalignment has resulted in the compression of a spinal nerve root or the spinal cord itself.
The absence of nerve compression, however, may cause the condition to go unnoticed and
undiagnosed. Grade III and IV spondylolisthesis may also result in the symptoms of nerve compression,
such as traveling pain or numbness and tingling in the extremities, but are also likely to lead to physical
deformity in the spine and are less likely to be missed.
Understanding Treatment
The type of spondylolisthesis treatment that will be recommended to the
patient depends on the extent of the spondylolisthesis. For example, if a
patient is diagnosed with Grade I or II spondylolisthesis, a regimen of
conservative techniques may be a viable option, assuming the spinal column is
stable. In the event that nonsurgical options do not provide the patient with
the pain relief they require, there are several different surgical approaches that
may be considered, depending on the patient. Only a doctor will be able to
recommend the precise combination of treatments that will offer the patient
the best chance to overcome his or her discomfort.
Nonsurgical Treatment
For most people suffering from degenerative spine conditions such as spondylolisthesis, the first course
of action is a regimen of conservative treatments – assuming that the spine is stable and the patient’s
pain isn’t debilitating or rapidly worsening. The important thing to understand about conservative
treatment is that it is not intended to “cure” spondylolisthesis. These techniques will not undo severe
spinal deterioration, reverse the effects of aging, regenerate lost cartilage, or make any other significant
changes to the spinal anatomy. Instead, conservative treatment is designed to manage the patient’s
pain, increase or maintain flexibility in the spine, and reduce the strain on the affected region of the
spine over time.
A few examples of the types of treatments that may initially be recommended to a patient suffering
from spondylolisthesis include:
The use of nonsteroidal anti-inflammatory drugs, pain medications, or muscle relaxants
The application of a heating element or ice
Low-impact exercises such as walking, jogging or swimming
Stretching techniques
Limited rest

3. Lifestyle changes such as healthy dieting, limiting alcohol consumption, or quitting smoking
Additionally, many individuals turn to alternative medicine as either a complement or an alternative to
traditional medicine. The use of deep tissue massage, chiropractic therapy, acupuncture, and other
holistic remedies are quite popular.
Surgery
Unfortunately for some patients suffering from spondylolisthesis, surgery is the only realistic
spondylolisthesis treatment available. However, depending on the specific diagnosis, there may be a
couple of different surgical approaches that may be considered. When the patient suffers from low
grade spondylolisthesis and his or her spine is stable, for example, an
endoscopic procedure may be an effective means for alleviating nerve
compression on an outpatient basis. During this type of minimally
invasive operation, the orthopedic surgeon is able to access the spinal
column through a small incision and can create additional canal space in
order to alleviate nerve compression and abate symptoms.
Alternatively, when a flexion and extension X-ray indicates that the spinal column has become unstable,
there is a good chance that spinal fusion is the only real treatment option available. During this type of
surgery, the intervertebral disc is carefully removed and replaced with a bone graft. The adjacent
vertebrae are further stabilized with surgical hardware and the spine is stabilized. This surgery will
require a permanent sacrifice to the flexibility to the spine and entails a lengthy period of rehabilitation
after the surgery, but for a select segment of the population it is a necessary means of limiting future
spine problems and addressing chronic pain.
To learn more about spondylolisthesis treatment, speak with a doctor today.