Spondylolysis and Spondylolisthesis

Spondylolysis is a stress fracture in a small bone in the spine called the pars interarticularis. It most often affects the lower back. When that fracture weakens enough for one vertebra to slip forward over the one below it, the condition is called spondylolisthesis.

These conditions can occur from repetitive stress, overuse, congenital differences in spinal anatomy or trauma. Although common in young athletes — especially gymnasts and football players — spondylolysis and spondylolisthesis can affect adults of all ages.

Symptoms to watch for

Symptoms vary but often include:

Persistent lower back pain, especially with activity
Pain that radiates into the buttocks or legs
Muscle tightness or spasms in the lower back
Numbness, tingling or weakness in the legs
Changes in posture or walking pattern

Some people with mild spondylolysis never have symptoms. Others may notice worsening pain with bending, lifting or twisting.

How these conditions are diagnosed

Your provider will begin with a thorough history and physical exam to assess pain, flexibility and neurological signs such as reflex changes or weakness. Imaging studies may include:

X-rays to detect fractures or vertebral slippage
MRI or CT scans to evaluate soft tissue and nerve involvement
Bone scan in selected cases to assess activity at the fracture site
Diagnosis is essential to guide treatment and to rule out other causes of back pain.
Nonsurgical treatment options
Many patients improve with conservative care, including:
Physical therapy to strengthen core and back muscles
Activity modification to reduce stress on the spine
Anti-inflammatory medications as recommended by your provider
Bracing in select cases to support healing

These approaches can reduce pain, improve function and help patients return to daily activities.

When surgery is considered

Surgery may be recommended when:

Pain does not respond to conservative care
Neurological symptoms worsen
There is significant vertebral slippage affecting stability
Quality of life is limited due to persistent symptoms

The goal of surgery is to relieve pressure on nerves, stabilize the spine and restore alignment.

Surgical approaches we use

Tanner Spine Surgery offers personalized surgical care that may include:

Spinal fusion: Joining affected vertebrae to prevent painful motion
Decompression: Removing bone or tissue pressing on nerves
Instrumentation: Using screws or rods to enhance stability

Your surgeon will discuss the approach that best fits your anatomy, symptoms and goals.

Recovery and what to expect

After surgery, most patients:

Begin walking the same day or next day
Work with physical therapy to rebuild strength
Gradually resume normal activities over weeks to months

Recovery varies by individual. Your care team will provide a customized plan to help you heal safely and effectively.

Spondylolysis & Spondylolisthesis Frequently Asked Questions

What causes spondylolysis and spondylolisthesis?
They can result from stress fractures, repetitive sports injury, congenital spinal differences or trauma.

Is surgery always necessary?
No. Many patients respond well to nonoperative care. Surgery is considered when symptoms persist or neurological issues occur.

How long is recovery from surgery?
Most patients return to regular activities in 8 to12 weeks, with full healing continuing over several months as guided by your surgeon.