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What is Spondylolisthesis?

Spondylolisthesis is a condition in which a bone (vertebra) in the spine begins to shift forward or backward out of its proper position onto the bone below it. It is a common cause of low back pain in young athletes.

What You Can Expect at UTHealth Neurosciences

At the Spine Center at UTHealth Neurosciences, fellowship-trained neurologists, neurosurgeons, neuro-oncologists, interventional pain management specialists, and radiation oncologists work together to determine the care each patient needs, discussing treatment options as a group. The goal of this approach is to save our patients time and money and allow our specialists to share each other’s insights, leading to better treatment decision-making and outcomes.

We first investigate options for nonsurgical treatment, including medical management, pain management, physical therapy, rehabilitation, and watchful waiting. When surgery is needed, our neurosurgeons routinely employ innovative minimally invasive techniques. Throughout the treatment process, our team works closely with the doctor who referred you to ensure a smooth transition back to your regular care plan. While you are with us, you can expect expert care, excellent communication, and genuine compassion.

Causes of Spondylolisthesis

Usually spondylolisthesis results from spondylolysis, a crack or stress fracture in the pars interarticularis, the thin portion of the vertebra that connects the upper and lower facet joints.

In children, spondylolisthesis usually occurs between the fifth bone in the lower back (lumbar vertebra) and the first bone in the sacrum (pelvis) area. The injury is most commonly seen in children and adolescents who participate in sports that involve repeated stress on the lower back, including football, weightlifting, and gymnastics. Repetitive stress can cause a fracture on one or both sides of the vertebra. It also may be caused by a birth defect in the spine or an acute injury.

In adults, the most common cause is abnormal wear on the cartilage and bones, such as arthritis. The condition affects people over the age of 50, and is more common in women than in men. Bone disease and fractures also can cause spondylolisthesis.

Genetics may play a role in spondylolisthesis; some people are born with thinner-than-normal vertebral bone.

Early Signs of Spondylolisthesis and Diagnosis

Symptoms of spondylolisthesis may vary from none to mild to severe. The most common symptom is low back pain.

The condition can cause lordosis (swayback). In later stages it may result in kyphosis (roundback) as the upper spine falls off the lower spine. General symptoms are lower back pain; muscle tightness in the hamstrings; pain, numbness, or tingling in the thighs and buttocks; tenderness in the area of the vertebra that is out of place; weakness in the legs; and difficulty standing and walking.

Our spine specialists diagnose spondylolisthesis by taking a thorough medical history, conducting a physical exam, and asking you to undergo imaging studies that may include X-ray, CT scan, or MRI scan.


Treatment depends on how severe the condition is. Initial treatment may include rest, physical therapy, nonsteroidal anti-inflammatory drugs, oral corticosteroids, and/or bracing that limits movement of the spine and allows the fracture to heal.

Surgery may be recommended for people who have severe or high-grade slippage of the vertebra in which more than 50% of the fractured vertebra slips forward on the vertebra below it. The procedure most often recommended for people with lumbar spondylolisthesis is spinal fusion.

The Spine Center at UTHealth Neurosciences brings together a multidisciplinary team of board-certified, fellowship-trained neurosurgeons, neurologists, researchers, and pain management specialists who work together to help provide relief for even the most complex problems.

People who suffer from radiculopathy, spondylosis, spinal stenosis, herniated disc, degenerative disc disease, peripheral nerve disorders, spinal cord injury, or other trauma benefit from our collaborative expertise in managing spine disorders. Before recommending surgery, your physician team will investigate options for nonsurgical treatment, including medical management, interventional pain management, physical therapy, and watchful waiting when appropriate.

Spine Disease and Back Pain

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At UTHealth Neurosciences, we offer patients access to specialized neurological care at clinics across the greater Houston area. To ask us a question, schedule an appointment, or learn more about us, please call (713) 486-8100, or click below to send us a message. In the event of an emergency, call 911 or go to the nearest Emergency Room.

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