How Does Degenerative Spondylolisthesis Create Back Pain and Leg Pain?

Degenerative Spondylolisthesis is an extremely common spinal condition that causes back pain along with hip, buttock, and leg pain. The term "spondy" means spine and "listhesis" means slip. From degenerative arthritis occurring, one vertebral body ends up shifting on the one below it, and this can cause pain from either:

1. Spinal arthritis


2. Spinal instability


3. Pinching nerves from the slip (spinal stenosis)

The spinal canal has a typical cross sectional area that allows nerve roots to get out just fine normally. But if one vertebra slips and thereby shifts its position on top of another level, that cross sectional area decreases. You have a bony area that is shifting, but the surrounding soft tissues are shifted right with it.

This can pull traction on nerve roots that were previously very happy with the amount of space they had to exit from the spinal canal. With the slippage, those nerve roots may get pinched at one of 3 places:

1. Pinched nerve in the area where they come off of the spinal cord (dura)


2. The area as they enter the exit hole (foramen) from the spinal canal called the lateral recess


3. The exiting hole from the spinal canal, called the foramen

Either place of compression can produce symptoms of hip, buttock, and/or leg pain called spinal stenosis. Stenosis in this case refers to constriction of an anatomic circumference. If there instability when a person moves, such that the vertebra shifts when a person stands up and moves and then goes back upon sitting, this can create intermittent symptoms of back pain and/or spinal stenosis.

Unfortunately when spondylolisthesis occurs, it is a mechanical problem. We do not have a special powder or injection material that will fix it. However, degenerative spondylolisthesis is obviously not a fatal condition, and it doesn't cause paralysis.

So it can be treated conservatively with many options including:

1. Physical Therapy


2. Pain Management injections


3. Pain Medication


4. Chiropractic Treatment


5. Spinal Decompression Treatment

If these options fail, then surgery can work very well but should be considered as a last resort.