Spondylolisthesis Patient Handout

What is Spondylolisthesis?

Spondylolisthesis means a vertebra has slipped forward onto the vertebra below it. "Spondy" = vertebra, "listhesis" = slipping. This causes instability and can compress nerves, creating pain, weakness, or other symptoms.

Types of Spondylolisthesis

Degenerative Spondylolisthesis

• Most common type (80%)
• Due to age-related degeneration
• More common in ages 50+, women
• Usually mild slipping
• Often with stenosis

Isthmic Spondylolisthesis

• Defect in pars interarticularis
• Can be developmental or acquired
• Often ages 15-25 in athletes
• Risk for progression if young

Traumatic Spondylolisthesis

• From acute injury or fracture
• Less common

Pathological Spondylolisthesis

• From tumor or bone disease
• Rare

Symptoms

• Lower back pain (often non-radiating)
• Leg pain if nerves compressed
• Weakness or numbness
• Difficulty walking
• Kyphotic posture (forward leaning)
• Pain with extension (bending backward)
• Might have no symptoms if mild

Conservative Treatment

• Physical therapy (core strengthening critical)
• Anti-inflammatory medications
• Activity modification
• Epidural steroid injections (if nerve involved)

Success rate: 60-70% improve with conservative care

When Surgery Is Appropriate

• Progressive neurological deficit
• Persistent pain despite conservative treatment
• Significant functional limitation
• Instability requiring stabilization

MIS Surgical Options

MIS TLIF (Transforaminal Lumbar Interbody Fusion)

• Most appropriate for symptomatic spondylolisthesis
• Decompresses nerves + stabilizes with fusion
• Recovery: 4-8 weeks to full activity

Success rate: 85-90%

MIS Laminectomy (with or without fusion)

• If primarily stenosis with mild slip
• Nerve decompression focused
• Fusion added if significant instability