General Discussion

Treatments for spondylolisthesis depend on the symptoms you have and how severe they are.

Common treatments include:

avoiding activities that make symptoms worse, such as bending, lifting, athletics and gymnastics
taking anti-inflammatory painkillers such as ibuprofen or stronger painkillers on prescription
steroid injections in your back to relieve pain, numbness and tingling in your leg
physiotherapy to strengthen and stretch the muscles in your lower back, tummy and legs
The GP may refer you to a physiotherapist, or you can refer yourself in some areas.

Waiting times for physiotherapy on the NHS can be long. You can also get it privately.

Surgery for spondylolisthesis
The GP may refer you to a specialist for back surgery if other treatments do not work.

Types of surgery include:

spinal fusion – the slipped bone (vertebra) is joined to the bone below with metal rods, screws and a bone graft
lumbar decompression – a procedure to relieve pressure on the compressed spinal nerves
The operation is done under general anaesthetic, which means you will not be awake.

Recovery from surgery can take several weeks, but if often improves many of the symptoms of spondylolisthesis.

Talk to your surgeon about the risks and benefits of spinal surgery

https://www.nhs.uk/conditions/spondylolisthesis/#:~:text=Spondylolisthesis%20is%20where%20one%20of,common%20in%20the%20lower%20back.

The goals of treatment for spondylolysis and spondylolisthesis are to:

Reduce pain
Allow a recent pars fracture to heal
Return the patient to sports and other daily activities
Nonsurgical Treatment
For most patients with spondylolysis and low-grade spondylolisthesis, back pain and other symptoms will improve with nonsurgical treatment.

Nonsurgical treatment may include:


Rest. Avoiding sports and other activities that place excessive stress on the lower back for a period of time can often help improve back pain and other symptoms.

Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs such as ibuprofen and naproxen can help reduce swelling and relieve back pain.


Physical therapy. Specific exercises can help improve flexibility, stretch tight hamstring muscles, and strengthen muscles in the back and abdomen.

Bracing. Some patients may need to wear a back brace for a period of time to limit movement in the spine and allow a recent pars fracture the opportunity to heal. Although athletes wtih sudden or acute onset of pain are candidates for brace treatment, patients with longer-term pain are not. In these patients, the stress fracture will have a low chance of healing, even after several months in a brace.

Over the course of treatment, your child's doctor will take periodic X-rays to determine whether the vertebra is changing position.

Surgical Treatment
Surgery may be recommended for spondylolisthesis patients who have:

Severe or high-grade slippage
Slippage that is progressively worsening
Back pain that has not improved after a period of nonsurgical treatment
Spinal fusion between the fifth lumbar vertebra and the sacrum is the surgical procedure most often used to treat patients with spondylolisthesis.


The goals of spinal fusion are to:

Prevent further progression of the slip
Stabilize the spine
Alleviate significant back pain
Surgical Procedure
Spinal fusion is essentially a welding process. The basic idea is to fuse together the affected vertebrae so that they heal into a single, solid bone. Fusion eliminates motion between the damaged vertebrae and takes away some spinal flexibility. The theory is that if the painful spine segment does not move, it should not hurt.

During the procedure, the doctor will first realign the vertebrae in the lumbar spine. Small pieces of bone — called bone graft — are then placed into the spaces between the vertebrae to be fused. Over time, the bones grow together — similar to how a broken bone heals.


Prior to placing the bone graft, your doctor may use metal screws and rods to further stabilize the spine and improve the chances of successful fusion.

In some cases, patients with high-grade slippage will also have compression of the spinal nerve roots. If this is the case, your doctor may perform a procedure to open up the spinal canal and relieve pressure on the nerves before performing the spinal fusion.

https://orthoinfo.aaos.org/en/diseases--conditions/spondylolysis-and-spondylolisthesis/