Spondylolisthesis is a condition in which a bone (vertebra) in the spine moves forward out of the proper position onto the bone below it.
In children, spondylolisthesis usually occurs between the fifth bone in the lower back (lumbar vertebra) and the first bone in the sacrum (pelvis) area. It is often due to a birth defect in that area of the spine or sudden injury (acute trauma).
In adults, the most common cause is abnormal wear on the cartilage and bones, such as arthritis.
Bone disease and fractures can also cause spondylolisthesis. Certain sport activities, such as gymnastics, weight lifting, and football, put a great deal of stress on the bones in the lower back. They also require that the athlete constantly overstretch (hyperextend) the spine. This can lead to a stress fracture on one or both sides of the vertebra. A stress fracture can cause a spinal bone to become weak and shift out of place.
Spondylolisthesis may vary from mild to severe. A person with spondylolisthesis may have no symptoms.
The condition can lead to increased lordosis (also called swayback). In later stages, it may result in kyphosis (roundback) as the upper spine falls off the lower spine.
Symptoms may include any of the following:
Lower back pain
Muscle tightness (tight hamstring muscle)
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
Signs and Tests
Your doctor will examine you and feel your spine. You will be asked to raise your leg straight out in front of you. This may be uncomfortable or painful.
Temporary or permanent damage of spinal nerve roots, which may cause sensation changes, weakness, or paralysis of the legs
When to Contact a Medical Professional
Call your health care provider if:
The back appears to curve a lot
You have back pain or stiffness that does not go away
You have pain in the thighs and buttocks that does not go away
You have numbness and weakness in legs
Earle JE, Siddiqui IJ, Rainville J, Keel JC. Lumbar spondylolysis and spondylolisthesis. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 49.
Spiegel DA, Dormans JP. Spondylolysis and spondylolisthesis. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 671.6.
C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.