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Normally, the vertebrae stand neatly stacked on top of one another. Ligaments and joints support the spine. Spondylolisthesis alters the alignment of the spine. In this condition, one of the vertebrae slips forward or backward over the one below it. As the bone slips forward or backward, the nearby tissues and nerves may become irritated and painful.
Spondylolisthesis can be present at birth or develop during childhood or later in life. The disorder may result from the physical stresses to the spine from carrying heavy objects, weightlifting, football, gymnastics, trauma and general wear. As the vertebral components degenerate, the spine’s integrity is compromised.
A traumatic fracture in the bony ring can lead to slippage when the fracture goes completely through both sides of the ring. The facet joints can no longer provide a buttress, allowing the vertebra with the crack in it to slip forward.
The spine ages and wears over time. This also causes changes in the spine that can lead to spondylolisthesis. These changes affect the structures that normally support healthy spine alignment. Degeneration in the disk and facet joints of a spinal segment causes the vertebrae to move more than they should. The segment becomes loose, and the added movement takes a toll on the structures of the spine. The disk weakens, pressing the facet joints together. Eventually, the support from the facet joints becomes ineffective, and the top vertebra slides forward. Spondylolisthesis from degeneration usually affects people over 40. It usually involves slippage of L4 over L5.