Spondylolysis and Spondylolisthesis

What are spondylolysis and spondylolisthesis?

Your spine supports your body and allows you to move with strength and flexibility. Sometimes small stress fractures develop in a bone of the lower spine. This is known as spondylolysis. If fractures occur on both sides of the same vertebra, the bone can slip forward over the one beneath it. That forward movement is known as spondylolisthesis.

Spondylolysis and spondylolisthesis affect about 5–6% of people and can occur in children, teens and adults.

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Illustration comparing a healthy cervical spine to one with spondylosis, labeled with bulging disk, bone spurs, and narrowed disk space.

Understanding spondylolysis and spondylolisthesis

The lower (lumbar) spine is made up of vertebrae connected by discs, joints and ligaments. A small section of bone called the pars interarticularis helps link these structures. Repeated strain on this area can cause a stress fracture (spondylolysis).

When the fracture occurs on both sides of the vertebra, the bone may lose stability and shift forward, resulting in spondylolisthesis. In many adults, this slipping is mild. In adolescents, especially during growth spurts, the shift can be more noticeable.

Overview

Symptoms

Symptoms are different from person to person. Some people have mild discomfort, while others experience ongoing pain. You may notice:

Lower back pain that worsens with activity, especially bending or twisting
Pain that spreads to the buttocks, thighs or legs
Muscle tightness or stiffness
Numbness, tingling or weakness in one or both legs
Changes in posture or walking

Causes

Spondylolysis most often develops from repetitive stress on the lower back. It is common in young athletes who participate in sports that involve frequent bending or twisting, such as gymnastics, football or weightlifting. Over time, the repeated strain can interfere with the bone’s ability to heal, leading to a fracture.

When fractures occur on both sides of the vertebra, the bone may shift forward, causing spondylolisthesis.

Diagnosis

To diagnose your condition, your spine specialist will begin with a thorough evaluation, including a physical exam and review of your symptoms and activity history. Your doctor may order imaging tests such as X-ray, CT scan or MRI to confirm a stress fracture or vertebral slippage and to check for nerve involvement.

Why treatment matters

Getting an early and accurate diagnosis can help most people with spondylolysis and spondylolisthesis recover well and return to normal activities.

Early care can relieve pain and help keep your condition from getting worse. Many people improve with nonsurgical treatment, including rest, activity modification, physical therapy or bracing to reduce strain, strengthen supporting muscles and improve stability.

If your pain continues, gets worse or nerves become compressed, our specialists may recommend additional options such as targeted injections or surgery to help relieve your symptoms and promote healing.