Spondylolisthesis

Spondylolisthesis occurs when one vertebra slips forward relative to the vertebra below it, which can lead to back pain, nerve compression, and difficulty with standing or walking. The condition is often related to degenerative changes in the spine, but may also result from structural defects or prior injury.

Aqib Zehri, MD, is a fellowship-trained neurosurgeon in Portland, Oregon, specializing in complex spine care. He evaluates and treats spondylolisthesis using a comprehensive, individualized approach, including minimally invasive and advanced surgical techniques when appropriate.

What is spondylolisthesis?

Spondylolisthesis occurs when one vertebra slips forward relative to the vertebra below it. This shift can place pressure on nearby nerves and affect spinal stability.

It may develop due to:

• Degenerative changes in the spine over time

• Stress fractures or defects in the vertebra

• Congenital alignment issues

• Trauma or prior spine surgery

As the condition progresses, it can lead to:

• Back pain

• Nerve compression

• Difficulty with standing or walking

What are the symptoms of spondylolisthesis?

Symptoms vary depending on the degree of slippage and nerve involvement. Common symptoms include:

• Lower back pain that worsens with standing or activity

• Pain that radiates into the buttocks or legs

• Numbness, tingling, or weakness in the legs

• Muscle tightness or stiffness

• Difficulty standing or walking for extended periods

In more advanced cases, patients may develop:

• Significant nerve compression

• Reduced mobility and function

How is spondylolisthesis diagnosed?

Diagnosis begins with a detailed history and physical examination, including a neurologic assessment.

Imaging may include:

• Standing X-rays to evaluate alignment and degree of slippage

• MRI to assess nerve compression and soft tissue structures

• CT scans to evaluate bony anatomy when needed

These studies help determine:

• Severity of the condition

• Presence of nerve involvement

• Need for surgical vs non-surgical treatment

What are the treatment options?

Treatment depends on:

• Symptom severity

• Degree of slippage

• Overall spinal stability

Non-surgical treatment may include:

• Physical therapy to improve strength and stability

• Medications to manage pain and inflammation

• Targeted injections for nerve-related symptoms

Surgical treatment may be considered when there is:

• Persistent pain despite conservative care

• Spinal instability

• Significant nerve compression

Surgical options may include:

• Minimally invasive decompression

• Spinal stabilization with instrumentation

• Robotic-assisted techniques for precision

The goal is to:

• Relieve nerve compression

• Restore spinal stability

• Improve overall function

Take the next step

If you are experiencing symptoms of spondylolisthesis or have been told you may need surgery, a comprehensive evaluation can help clarify your options.

Call the office or request an appointment online to get started.