Ohio State’s Comprehensive Spine Center offers all available treatment options for spondylolisthesis and considering your lifestyle and short- and long-term goals as we design a treatment plan uniquely for you.

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Spondylolisthesis is a condition in which a bone (vertebra) in the spine slips forward or backward in relation to the bone below it. It occurs most frequently in the lower back but can affect any vertebra. Low back pain, leg pain and weakness in the legs can result if the bone that is out of position significantly narrows the spinal column and begins to press on nerves.

Causes of spondylolisthesis include:

  • Congenital (something you are born with) defect of the vertebral joint. This usually occurs in the lower spine where the lumbar spine and sacrum come together. The defect allows a lumbar vertebra to slip forward over the sacrum
  • Stress “micro-fracture” in the bone due to overstretching and overuse. This can occur with sports activities such as gymnastics, weight lifting, ice skating and football
  • Aging or overuse-related wear on the spinal joints
  • Fractures
  • Tumors

Rest and anti-inflammatory medication resolve most cases, but occasionally physical therapy or surgery may be required.

What grade of spondylolisthesis do I have?

Like many other conditions, spondylolisthesis can be measured using a grading system, where your spondylolisthesis grade is based on the degree of displacement of your vertebrae. Grades of spondylolisthesis influence what symptoms you might experience as well as what treatment you will likely receive.

The grade of your condition is based on the distance from the posterior edge of the superior body of the vertebrae to the same edge of the inferior vertebral body. The ratings range from spondylolisthesis grade 1 to spondylolisthesis grade 5: grade 1 spondylolisthesis being least severe and grade 5 most severe. 

To diagnose your spondylolisthesis grade, your provider may order:

  • X-rays of the spine
  • Computed tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Electromyography (EMG) studies — tests that measure the electrical activity of muscles and nerves

 

Why choose Ohio State for treatment of spondylolisthesis?

Multidisciplinary Team: When you come to The Ohio State University Wexner Medical Center’s Comprehensive Spine Center, we determine the source of your pain, accurately diagnose the severity of your condition and choose which least-invasive treatment approach will restore you to the highest level of function possible.

Among the experts at our Comprehensive Spine Center are:

  • Physical medicine and rehabilitation physicians
  • Physical therapists
  • Radiologists
  • Neurologists
  • Spine surgeons with neurosurgical and orthopedic training
  • Pain specialists/anesthesiologists

Comprehensive Care: Ohio State offers all available treatment options for spondylolisthesis and provides realistic expectations for the treatment you choose. We consider your lifestyle and short- and long-term goals as we design a treatment plan uniquely for you. 

Physical Therapy Expertise: Our physical therapists specialize in spine conditions and work with you to alleviate pain and improve strength and flexibility.

Surgical Expertise: Our surgeons are fellowship-trained in complex spine surgeries. We perform more complex spine surgeries than any other medical center in central Ohio.

Research: You will benefit from Ohio State’s connections to national and international studies that provide you with the most current treatment methods and techniques in spondylolisthesis treatment.

Spine Center Registry: Through Ohio State’s Comprehensive Spine Center registry, we track our patients’ outcomes, including physical function and quality of life, and compare these to national and international results to help us select the most effective treatment methods.

 

Diagnosis

Diagnosing Spondylolisthesis

Following a thorough history, physical and neurological exams, our spine surgeons may recommend any of the following tests to confirm whether a bone in your spine is abnormally aligned. All tests are available within the Comprehensive Spine Center:

  • X-rays 
  • Computed tomography (CT) scan
  • Magnetic resonance imaging (MRI)
  • Electromyography (EMG), which can detect muscle weakness due to nerve problems

Treatment

Treating Spondylolisthesis

With expertise gathered from treating large numbers of people with spondylolisthesis, Ohio State’s spine specialists are best able to determine whether you are likely to benefit from non-operative care.

We offer treatments ranging from physical therapy to the most complex spine surgeries. Physicians, therapists and other care providers work together to provide you with options that increase mobility and reduce pain. Most people who come to the Spine Center do not require surgery.

Nonsurgical Treatments

One of Ohio State’s strengths is our physical therapy program, with therapists who specialize in spine conditions. Following an examination of posture, spine mobility, strength and flexibility, our physical therapists customize a plan for you. We take into account any impairments or functional limitations you have. Typically, you will work one-on-one with a therapist on pain-relieving movement strategies and on improvements in strength and flexibility.

Additional nonsurgical treatments include: 

  • Education on back care and recommendations for specific needs (such as job demands, recreational activities, home set-up)
  • Real-time ultrasound imaging (RUSI) of movement in in the spine area to retrain the deep stabilizing musculature of your spine (a highly researched, evidence-based intervention)
  • A back brace to limit spine movement
  • Oral or injected medication for pain management
  • Rest

Most people return slowly to full function, including athletic activity.

Surgical Treatments

You may need surgery if a bone that has slipped is likely to cause damage to nerves and the surrounding spinal structure or is causing severe pain or muscle weakness in one or both legs. 

Our surgeons can perform minimally invasive surgery to correct the symptoms of spondylolisthesis. The surgeon makes tiny incisions in the back and works through a tube to minimize skin and muscle damage, reduce blood loss and reduce post-surgical pain.

At Ohio State, we can use both minimally invasive surgery and conventional surgical techniques for these procedures:

  • Decompression surgery (laminectomy) to remove part of the vertebra and relieve pressure on your spinal cord or nerves
  • Spinal fusion surgery to fuse a severely slipped bone with the vertebra below it and restore stability to the spinal column

Most people who have decompression or fusion surgery can return to full function, including sporting activities.

Research

Research

Ohio State performs innovative research in the laboratory, as well as through clinical trials. 

Enroll in a clinical trial

Areas of focus include:

Spinal Fusion Study: A clinical trial currently under way at Ohio State is testing whether vertebrae being fused during minimally invasive surgery can be held together with screws on one side instead of on both sides of the bone. Placing screws on only one side of the bone results in shorter surgery time, less blood loss and less pain following surgery.

Biomechanical Testing: We also are doing biomechanical testing to assess the spine before and after surgery. A specialized vest helps us measure the effectiveness of surgery. It ultimately may provide valuable information about which treatment methods will best increase mobility and function of the spine.

Our Doctors

Additional Information

Please obtain a physician referral before scheduling with our Spine Center and request previous imaging studies (e.g., MRI, CT, X-ray) on a CD from the place where your tests were performed. Please bring to your appointment these and other test results related to your back (e.g., EMGs, bone density reports, ultrasound reports) from your doctor(s).

Preparing for your visit

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