Spondylolisthesis · Scottsdale, Arizona
Spondylolisthesis matters when it explains your pain, nerve symptoms, loss of function, or spinal instability. The goal is to identify which findings are meaningful—and choose the least disruptive treatment that reliably addresses them.
Is the slip incidental—or is it producing nerve compression, instability, and functional loss?
Understanding the condition
Spondylolisthesis describes one vertebra shifting forward relative to the bone below it. Some slips are painless and discovered incidentally. Others narrow the space available for nerves, change spinal mechanics, or create abnormal motion that limits standing, walking, work, or recreation.
The amount of translation matters, but it does not determine treatment by itself. A meaningful evaluation connects the history, neurologic examination, standing alignment, dynamic motion, and MRI findings before recommending a plan.
Two common patterns
Usually associated with age-related change
Disc height loss, facet arthritis, and ligament changes can allow one level to translate. Spinal stenosis often develops at the same level, producing leg pain, numbness, heaviness, or reduced walking tolerance.
Common focus: nerve compression · dynamic stability · alignmentAssociated with a pars defect or stress fracture
A defect in the pars interarticularis separates the front and back portions of a vertebra, most often becoming symptomatic later as the disc or neural foramen changes. Back pain, leg pain, or both may result.
Common focus: pars anatomy · foraminal narrowing · disc healthWhen to seek evaluation
Spondylolisthesis can present as mechanical back pain, nerve-related leg symptoms, loss of walking tolerance, or a combination. The pattern helps determine what should be investigated next.
A disciplined evaluation
A diagnosis becomes useful only when it explains the symptoms and shows what is mechanically or neurologically wrong.
Back pain, leg symptoms, walking tolerance, posture, weakness, and prior treatment response help determine whether the slip is actually responsible for the problem.
Standing X-rays show the degree of translation and overall alignment. Flexion-extension views can reveal excessive motion or dynamic instability.
MRI shows the discs, nerves, and areas of central or foraminal stenosis—and whether those findings match the symptoms and examination.
When needed, CT provides additional detail about a pars defect, facet joints, prior fusion, bone quality, or anatomy relevant to surgical planning.
Individualized treatment
Treatment should match both the symptoms and the mechanics. The objective is to relieve the problem that limits function while preserving healthy motion, muscle, and bone whenever the anatomy allows.
Dr. Burns' decision framework
Dr. Burns has a special clinical interest in spondylolisthesis and in matching the surgical strategy to the individual pattern of instability, nerve compression, alignment, and patient goals.
Request an evaluationCommon questions
No. Some slips cause no symptoms, and many symptomatic patients improve with activity modification, physical therapy, medication, or targeted injections. Surgery is considered when the diagnosis clearly explains persistent limitations, neurologic symptoms, or instability despite appropriate nonsurgical care.
Not by itself. The grade describes how far one vertebra has translated, but treatment also depends on symptoms, nerve compression, dynamic motion, alignment, bone quality, and the condition of the discs and facet joints.
Sometimes. In selected patients with a stable slip and symptoms driven mainly by nerve compression, decompression without fusion may be considered. When abnormal motion, foraminal collapse, deformity, or mechanical instability is central to the problem, stabilization may be needed.
For appropriately selected patients, minimally invasive decompression or fusion techniques can reduce unnecessary tissue disruption while addressing nerve compression, alignment, and stability. The technique is chosen around the anatomy—not simply the size of the incision.
New loss of bowel or bladder control, numbness in the saddle region, or rapidly progressive leg weakness can indicate severe nerve compression and require immediate emergency evaluation.
Medical review
Written and medically reviewed by Keven S. Burns, MD, board-certified orthopaedic spine surgeon. Last reviewed August 16, 2026.
Spondylolisthesis evaluation
If a slipped vertebra, back pain, sciatica, or reduced walking tolerance is changing how you live, a focused evaluation can clarify what is causing the problem and which options make sense.