Cervical Spondylolisthesis: Symptoms, Causes & Treatment

Think about living every day with constant pain in your lower back, the feeling of immobility, and recurring aches moving down to your legs. A lot of people all over the world are living with this feeling, and it has a medical term for it, “Spondylolisthesis”. This term might sound a little intimidating, but understanding what is cervical spondylolisthesis, cervical or lumbar spondylolisthesis causes, symptoms, and treatment can help you recover faster. 

Whether you are diagnosed with this disease or a loved one is dealing with these issues, this exclusive blog will help you understand the basics of cervical spondylolisthesis.

What is Spondylolisthesis?

Spondylolisthesis, also known as cervical Spondylolisthesis, is a medical condition where your vertebrae, bones of your spine, move out of place over the vertebrae below it. This misalignment of the spine can result in pain or sometimes nerve damage due to compression and in the worst case scenario, can hinder the body functioning and movement. 

This condition can occur anywhere in the spine. In most cases it occurs in the lumbar spine or lower back. It can also effect cervical spine (neck area) or the base of your back just below the ribs or thoracic spine.

How do you Grade Spondylolisthesis?

The extent of vertebral slippage defines the grade of spondylolisthesis, which is categorized using the Meyerding classification. The Meyerding classification is a grading system used to assess the severity of spondylolisthesis. It assigns Grades I through V based on the percentage of slippage seen on standing, neutral lateral lumbar X-rays:

• Grade I: 1–25% slippage
• Grade II: 26–50% slippage
• Grade III: 51–75% slippage
• Grade IV: 76–100% slippage
• Grade V: Complete slippage, known as spondylolisthesis

Accurately identifying both the degree and cause of slippage is essential for creating an effective treatment strategy. With that in mind, let’s explore the underlying causes.

Causes of Spondylolisthesis

Spondylolisthesis occurs when a vertebra shifts forward relative to the one beneath it. Cervical spondylolisthesis causes can be following, ncluding:

• Direct trauma to the spine
• Naturally thinner or weaker vertebrae
• Age-related degeneration
• Previous spinal surgery
• Rapid growth during adolescence
• Congenital (birth) defects
• Sports-related injuries
• Underlying conditions like spinal tumors or osteoporosis

What are the Types of Spondylolisthesis?

On the basis of its causes, we can divide spondylolisthesis into different classes. This classification helps in the correct diagnosis and selection of the best treatment for this issue. Here are the main types of Spondylolithesis:

Congenital (Dysplastic) Spondylolisthesis

This type is present from birth and results from abnormal development of part of the spine, usually the base of the lumbar vertebrae. The malformed bone structure can cause the vertebra to slip forward over time.

Isthmic Spondylolisthesis

Caused by a stress fracture or defect in the pars interarticularis—a small segment of bone connecting the joints of the spine. It often develops in childhood or adolescence, especially in those who play sports involving repeated back extension.

Degenerative Spondylolisthesis

Occurs due to age-related changes in the spine, such as disc degeneration and joint arthritis. These changes reduce stability in the vertebrae, allowing one to slip forward, typically in older adults.

Traumatic Spondylolisthesis

Results from a sudden injury, such as a fall or accident, that causes a fracture or dislocation in the spine. The trauma weakens the vertebrae, leading to slippage.

Pathological Spondylolisthesis

Caused by conditions like tumours, infections, or osteoporosis that weaken the spinal structures. These diseases compromise bone integrity, making slippage more likely.

Post-surgical (Iatrogenic) Spondylolisthesis

Develops after spinal surgery, especially if stabilising structures are removed or weakened. It may occur as a complication when the spine becomes unstable following the procedure.

Identifying the Symptoms

The symptoms of spondylolisthesis can vary significantly. Some individuals may experience no discomfort at all, while others might suffer from intense pain. These symptoms often resemble those of other back conditions. Common signs include:

• Stiffness in the lower back
• Numbness or tingling in the legs
• Loss of bladder or bowel control
• Ongoing lower back pain
• Pain radiating to the legs or buttocks
• Muscle tightness or spasms

If you are experiencing any of these symptoms, it is important to seek medical advice. Early diagnosis is key to ensuring appropriate treatment for spondylolisthesis and reducing the risk of future complications. Let’s take a closer look at the available treatment options.

Spondylolisthesis Treatment

The appropriate treatment for spondylolisthesis depends on several factors, including the degree of vertebral slippage, the severity of symptoms, the patient’s age, overall health, and activity level.

Conservative (Non-Surgical) Treatment

For low-grade slips, such as Grade I or II, especially when symptoms are mild to moderate, non-surgical options are often effective. These typically involve rest, physiotherapy to strengthen the back and abdominal muscles, and lifestyle adjustments—such as avoiding activities that trigger or worsen symptoms.

Surgical Intervention

Surgery is generally considered when conservative measures fail or if the condition progresses, resulting in significant pain, nerve involvement, or impaired mobility. The most common surgical procedure is spinal fusion, which stabilises the affected vertebrae.

Physiotherapy

A tailored physiotherapy programme can help improve spinal stability, flexibility, and core strength. Exercises may include hamstring stretches, lower back strengthening, and posture correction to reduce pressure on the spine.

Bracing

In some cases, particularly in younger individuals or those with isthmic spondylolisthesis—a back brace may be recommended. This limits spinal movement, providing the affected area with a chance to heal and reducing pain during everyday activities.

Medication

Pain management often starts with over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs). For more severe discomfort, doctors may prescribe muscle relaxants or short-term use of opioids, although long-term use is generally avoided.

Epidural Steroid Injections

Corticosteroid injections may be advised for patients experiencing nerve pain due to nerve root compression. These injections can provide swift relief by reducing inflammation around the affected area.

Preventive Measures

While some types of spondylolisthesis (such as congenital forms) are difficult to prevent, others—particularly degenerative types, can be mitigated with certain proactive habits:

• Engage in regular exercise to strengthen core muscles and maintain flexibility
• Avoid high-impact sports, or wear protective equipment when participating in them
• Maintain a healthy body weight to reduce pressure on the spine
• Be mindful of early symptoms and attend routine spinal check-ups if you're at risk
• Practice safe lifting techniques and proper posture during physical activities

By taking these precautions, you can help safeguard your spine and reduce the likelihood of developing spondylolisthesis or worsening an existing condition.

Wrapping Up

Living with spondylolisthesis can be physically and emotionally challenging, but with the right knowledge, early diagnosis, and a proactive approach, it is entirely possible to manage the condition effectively. Taking care of your spine through healthy habits, regular exercise, and prompt medical attention can significantly improve quality of life and help prevent further complications. However, as with many health conditions, the financial aspect of treatment can be a concern for many families.

That’s why having comprehensive health insurance coverage is essential. A trusted plan like Niva Bupa Health Insurance can offer financial security and access to quality care when you need it most, helping you focus on recovery rather than expenses.

FAQs

1. Can spondylolisthesis heal on its own without treatment?

   Mild cases of spondylolisthesis, especially low-grade slips (Grade I or II), may improve with conservative treatments like physiotherapy, rest, and lifestyle changes. However, the condition typically does not "heal" on its own without proper care. Regular monitoring and medical guidance are important to prevent progression and manage symptoms.

2. Is exercise safe if I have spondylolisthesis?

   Yes, but it must be done under professional supervision. Low-impact exercises and physiotherapy can actually help strengthen the back and core, improve flexibility, and reduce pain.

3. Is spondylolisthesis a permanent condition?

   Spondylolisthesis is generally a long-term condition, but it can be well managed with the right treatment. In many cases, symptoms can be controlled or even eliminated through physiotherapy, bracing, and medication.

4. What makes spondylolisthesis worse?

   Spondylolisthesis can worsen with activities that strain the spine, such as heavy lifting, high-impact sports, or poor posture. Ignoring symptoms and delaying treatment may also lead to increased pain and nerve damage.