Spondylolisthesis​


Our spinal column is made of several vertebrae and the spinal cord passes through it. Spondylolisthesis is a disorder in which one of these vertebrae slips over another one, often compressing the spinal cord or some nerve roots, leading to pain. Usually spondylolisthesis occurs after a fracture and is a common cause of lower back pain in adolescent athletes. 

There are different types of spondylolisthesis, de​pending on what causes the disorder. These are:

  • Congenital spondylolisthesis: This type of spondylolisthesis is present at birth due to a birth defect of abnormal bone formation of the vertebrae.

  • Isthmic spondylolisthesis: This type of spondylolisthesis occurs because of small fractures in the bones of the vertebrae.

  • Degenerative spondylolisthesis: A common form of spondylolisthesis, this type occurs due to age-related degeneration of the discs between the vertebrae, with the discs losing their ability to resist movement by the vertebrae.

  • Traumatic spondylolisthesis: This is caused by a fracture in the spine due to a trauma or injury, such as a sports accident.

  • Spondylolisthesis due to a bone disease or infection: This occurs due to a disorder with the bones, such as osteoporosis, which weakens the spine.

  • Spondylolisthesis after spinal surgery: In some cases, spondylolisthesis may occur because of an incorrect surgical procedure.​

In mild cases of spondylolisthesis, symptoms may not be exhibited and you may not even know that you have the condition. However, in some cases the symptoms are apparently noticeable. These symptoms will depend on the location where it occurs in the spinal canal and also on the severity of displacement of the vertebrae. It usually occurs in the lower back, with accompanying signs and symptoms such as:

  • Lower back pain which spreads across the lower back

  • Pain in buttocks

  • Muscle spasms in the hamstring muscles at the back of the thighs

  • Tight hamstring muscles, which result in slightly bent knees and cause difficulty walking, in long strides

  • If the spondylolisthesis is pinching a nerve, pain may be felt all over the leg, together with tingling and numbness

  • Stiffness

  • Weakness in the legs

  • Tenderness in the area where the vertebra is displaced

  • Pain in the leg, back, or buttock pain that aggrevates when you bend over or twist

  • Loss of bladder or bowel control, in extreme cases​

​Spondylolisthesis can lead to quite painful symptoms, can affect your nerves too and may lead to reduced mobility and inactivity. Early diagnosis is important for ensuring maximum recovery for you after treatment. If you suspect that you may have any of the symptoms discussed above, especially tightness in your hamstrings and a tender spot along you lower spine, seek immediate medical advice from the Mind and Brain Service Line​ of the Aga Khan University Hospital.

​Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here​ are some tips to help get you started.

Your doctor will take your detailed medical history to evaluate your symptoms to make an initial diagnosis. Thereafter, your physical examination will be conducted, in which the doctor may ask you to change your position, such as bend down, to see how your movement is affected. The doctor will also feel along your spine for any tender areas that are painful to you.

Subsequently, further diagnostic tests will be requested to confirm this diagnosis. These tests include:

  • X-rays to get detailed images of the body’s bone structures

  • Magnetic resonance imaging (MRI) is a very effective way of looking for tumours. They are more detailed that CT scans.

  • Computed tomography (CT) scan produce detailed cross-sectional images of your brain and spinal cord (or other parts of the body).

The detailed images produce with the help of these imaging tests can clearly show the vertebrae and nerves involved in your particular case of spondylolisthesis.

For treatment of spondylolisthesis, your doctor will evaluate your health condition, your age and the severity of your disorder. At first, conservative, non-surgical methods of treatment will be recommended and monitored to see if symptoms improve through these. Some conservative treatment methods are:

  • Not indulging in strenuous physical activity till the pain subsides.

  • Non-steroidal anti-inflammatory (NSAID) medications to help reduce pain and inflammation (irritation and swelling)

  • Epidural steroid injections, in which medication is placed directly in the space surrounding the spine

  • A brace or back support might be used to help stabilize the lower back and prevent unnecessary movement

  • Stabilization exercises for your back with the help of physical therapy

  • In severe cases, surgery will be required. These included cases where symptoms do not improve after conservative treatment methods, or if you experience worsening pain over time. A severe displacement and unbearable muscle weakness will also require surgery to cure you of your symptoms.

​The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.

​Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.



The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the ​advice of your doctor or other healthcare professional provider. ​