Spinal Condition
Spondylolisthesis Treatment
Slipped Bone — Vertebral Instability
Spondylolisthesis occurs when one vertebra slips forward over the one below it — destabilising the spine and often compressing exiting nerve roots.
Understanding Spondylolisthesis
The most common form — isthmic spondylolisthesis — results from a stress fracture of the pars interarticularis, a small bone connecting the vertebral facet joints. Degenerative spondylolisthesis, more common in older adults, arises from facet joint arthritis causing instability. The slip is graded I (0–25%) to IV (75–100%). Low-grade slips are often managed non-surgically; high-grade or progressive slips may require spinal fusion to restore stability. Dr. Sparsh Jaiswal performs minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) — a percutaneous approach with markedly less blood loss and a faster return to activity.
infoCommon Causes
- Pars interarticularis stress fracture (isthmic type)
- Facet joint degeneration and arthritis (degenerative type)
- Congenital vertebral malformation
- High-impact sports (gymnastics, cricket fast bowling, weightlifting)
- Traumatic fracture-dislocation
- Post-surgical instability
symptomsKey Symptoms
- check_circleLower back pain aggravated by activity and relieved by rest
- check_circleTightness in the hamstrings causing difficulty walking
- check_circleRadiating pain or numbness into the buttocks and legs
- check_circleVisible step-off deformity at the base of the spine
- check_circleNeurogenic claudication — leg pain and weakness with walking
Diagnosis
Standing lateral X-rays reveal the slip and its grade. Flexion-extension views assess dynamic instability. MRI evaluates nerve compression; CT scan defines the bony anatomy for surgical planning.
verified_userMedically reviewed: May 2026 — Dr. Sparsh Jaiswal, MBBS DNB FISS FINM MNAMS · Apollo Hospitals, Indore (Reg: MP-16286 | MCI-19-30548)
Frequently Asked Questions about Spondylolisthesis
What is spondylolisthesis and is it dangerous?
Spondylolisthesis is the forward slippage of one vertebra over the one below it. Grade I–II slips (up to 50% displacement) are common and often manageable non-surgically with activity modification, core strengthening, and physiotherapy. Grade III–IV slips may require surgical stabilisation to prevent further slippage and nerve damage. The condition is not dangerous when appropriately monitored and treated.
Can spondylolisthesis be treated without surgery?
Grade I and many Grade II spondylolisthesis cases are successfully managed without surgery. Treatment includes physiotherapy to strengthen core and paraspinal muscles, activity restrictions (avoiding high-impact sports such as weightlifting and gymnastics), and spinal injections for associated pain. Surgery is recommended when there is progressive slip, neurological deficit, or pain that significantly limits daily activities despite 3–6 months of conservative treatment.
What surgery is performed for spondylolisthesis?
The standard surgical procedure is minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). Dr. Sparsh Jaiswal performs this through two small incisions using tubular retractors — preserving the muscles. A cage is placed between the vertebrae and percutaneous pedicle screws stabilise the level. Blood loss is typically under 100 mL and patients are mobile the following day with return to desk work in 2–3 weeks.
Which sports increase the risk of spondylolisthesis?
Sports involving repeated lumbar hyperextension — cricket (fast bowling), gymnastics, weightlifting, rowing, and wrestling — carry the highest risk. These activities stress the pars interarticularis (the weakest part of the posterior arch), and repetitive loading can cause a stress fracture (spondylolysis) that, if bilateral, leads to vertebral slippage (spondylolisthesis). Young athletes in these sports should be screened if they develop persistent lower back pain.
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