Spondylolisthesis is a spinal condition that occurs when one of the vertebrae in your spine slips out of place onto the vertebra below it. While the term may sound intimidating, understanding the different types of spondylolisthesis can help patients and caregivers better manage symptoms and seek the right treatment.
The condition varies significantly based on its cause, and accurate diagnosis is key to choosing the best treatment plan. The three main types, congenital, isthmic, and degenerative, differ in their onset, risk factors, and progression.
What Is Spondylolisthesis?
Spondylolisthesis literally means “slipped vertebra.” This misalignment most commonly occurs in the lower spine (lumbar region), though it can affect other spinal levels. The severity of the slip is classified into grades, with Grade I being mild and Grade IV being severe.
The condition can lead to symptoms such as lower back pain, stiffness, muscle tightness, and nerve compression causing radiating pain or numbness in the legs. Understanding the underlying cause helps determine the appropriate treatment, whether conservative care or surgical intervention is necessary.
Congenital Spondylolisthesis: Present from Birth
Congenital spondylolisthesis occurs due to abnormal development of the spine before birth. This malformation may include an underdeveloped facet joint or misaligned vertebrae, which predispose the spine to instability and eventual slippage.
- Who it affects: Though present from birth, symptoms often don’t appear until adolescence, when rapid growth or increased physical activity may put more pressure on the unstable segment. Children and teenagers may begin experiencing back pain, stiffness, or hamstring tightness.
- How it progresses: As the spine matures, the misalignment can worsen if not addressed. While some cases remain stable and asymptomatic, others may require monitoring or treatment to prevent further progression.
Isthmic Spondylolisthesis: Related to Stress Fractures
Isthmic spondylolisthesis is caused by a small stress fracture or defect in a specific part of the vertebra called the pars interarticularis. This defect is often due to repetitive stress or overuse, especially in individuals who participate in sports involving frequent hyperextension of the spine, such as gymnastics, football, or weightlifting.
- Who it affects: This type is most common in adolescents and young adults, particularly athletes. Often, the fracture occurs during growth years and may go unnoticed for some time.
- How it progresses: Over time, the defect can lead to slippage of the vertebra. The degree of slippage may remain stable or slowly increase. While some people may have no symptoms, others may develop persistent lower back pain, especially with activity.
- Management tip: Early diagnosis and physical therapy can help strengthen surrounding muscles and prevent worsening of the slippage.
Degenerative Spondylolisthesis: Age-Related Wear and Tear
Degenerative spondylolisthesis results from the gradual deterioration of the intervertebral discs and facet joints. These structures normally help maintain spinal alignment and flexibility. As they weaken over time due to ageing or arthritis, one vertebra may slip forward over another.
- Who it affects: This type is most common in older adults, especially women over the age of 50. Risk factors include ageing, spinal arthritis, obesity, and sedentary lifestyles.
- How it presents: Unlike congenital or isthmic types, degenerative spondylolisthesis usually develops slowly. Chronic lower back pain, stiffness, leg pain, or weakness are among the symptoms, particularly when standing or walking for long periods of time.
- Management tip: Lifestyle modifications, posture correction, and non-surgical spinal treatments are key to managing symptoms effectively.
Key Differences Between the Types
While all three types involve a slipped vertebra, the cause, progression, and management can vary greatly.
Congenital Spondylolisthesis
- Cause: Birth-related spinal malformation
- Age Group: Children and Teens
- Symptoms: Back pain and tight hamstrings
Isthmic Spondylolisthesis
- Cause: Repetitive stress fracture
- Age Group: Adolescents and Athletes
- Symptoms: Back pain and activity-related discomfort
Degenerative Spondylolisthesis
- Cause: Age-related disc/joint wear
- Age Group: Adults over 50
- Symptoms: Back pain, stiffness, and leg symptoms
Diagnosis and Treatment
Accurate diagnosis usually involves a combination of a physical exam, imaging tests like X-rays, MRI, or CT scans, and a review of symptoms. Treatment plans depend on the severity of the slip, symptoms, and patient age.
Non-Surgical Treatments Include:
- Physiotherapy: Strengthening core and back muscles to stabilise the spine.
- Posture Correction: Ergonomic improvements during work and daily activities.
- Pain Management: Heat therapy, anti-inflammatory measures, and guided activity.
- Non-Surgical Spinal Decompression Treatment: A non-invasive method to reduce nerve pressure and improve alignment.
- Lifestyle Modifications: Weight control, quitting smoking, and staying active.
Surgery is typically considered only if conservative treatment fails or if there’s progressive nerve damage, bowel/bladder dysfunction, or severe instability.
About ANSSI:
ANSSI Wellness focuses on improving the quality of life for patients suffering from spinal issues, aiming to provide relief where other conventional treatments have failed. Through advanced non-surgical spinal decompression treatment, ANSSI is committed to helping patients avoid surgery and recover in a safe, effective, and compassionate environment.
Connect with ANSSI Wellness on LinkedIn, Instagram, and Facebook for expert guidance.
