Degenerative Spondylolisthesis

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Spondylolisthesis occurs when one of the spine’s vertebrae (usually in the lower back area) slips out of place.

The condition is most often caused by a stress fracture that makes the vertebra unstable and allows it to slip forward. This type of fracture often occurs when a lot of stress and pressure is put on the back, usually from sports and sometimes by spinal problems that are present at birth.

Often there are no symptoms. Your doctor may discover it when seeing you for another health problem.

Spondylolisthesis Diagnosis & Treatment

Your doctor will ask about your medical history and perform a physical exam. Your doctor may also order diagnostic tests including:

  • X-rays
  • CT scan
  • MRI scan 

Classification of Spondylolisthesis

At UVA, we use the Meyerding Grading System to classify the degree of vertebral slippage. Slips are graded on the basis of the percentage that one vertebral body has slipped forward over the vertebral body below. 

Grade I:  1-24 percent 
Grade II: 25-49 percent  
Grade III: 50-74 percent 
Grade IV: 75-99 percent 
Grade V: Complete slip (100 percent), known as spondyloptosis

Your doctor considers the degree of slip and factors, such as severe, constant pain and neurological symptoms, when deciding on the most suitable treatment. Most cases of degenerative spondylolisthesis are Grade I or II. As a general guideline, the more severe slips (Grades III and above) are most likely to require surgical intervention.

Nonoperative Treatment 

Degenerative spondylolisthesis can be progressive and may cause spinal stenosis.

Most cases of degenerative spondylolisthesis are treated without surgery.

Spondylolisthesis Surgery 

You may require surgery if your condition progresses or causes neurologic problems, such as incontinence. Spinal instrumentation (i.e., rods, screws) and fusion (bone graft) are common procedures to stop slip progression and stabilize the spine.


Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.