MedStar Health’s team of skilled neurosurgeons and orthopedic spine surgeons specializes in managing spine conditions such as spondylolisthesis. We have extensive training in the most advanced surgical procedures, including conventional and minimally invasive techniques. Our approach depends on the severity of your condition and also incorporates non-operative procedures and current research.
We also take a personalized approach, spending time with you and your family to explain your condition and treatment options. Together, we discuss the risks and benefits of each treatment and address all your questions and concerns. Ultimately, you choose which treatment option will be best for you. We take a team approach, working with any other related specialists to manage your care. Spondylolisthesis treatments are located in the Washington, D.C., Baltimore, Maryland, and Virginia areas.
What is spondylolisthesis?
This condition develops when an injury or age-related degeneration pushes one or more spinal vertebrae out of place, which then can put pressure on the spinal nerves. The two common types of this disease are:
- Degenerative spondylolisthesis – The vertebrae lose flexibility and strength (either from natural aging or arthritis) and shrink, swell, and move out of place
- Spondylotic (isthmic) spondylolisthesis – This post-traumatic or congenital condition involves a break or stress fracture in a lower back bone can cause a vertebra to move out of place.
What causes spondylolisthesis?
Causes of spondylolisthesis can vary depending on age, lifestyle, and health history. In many adults, the most common cause is degenerative changes in the spine due to arthritis and natural wear over time. Some individuals are born with a congenital defect in the joints of the spine that makes them more prone to slippage. Injury to the spine can also trigger this condition, whether from repetitive stress that leads to small fractures, sudden trauma such as a sports injury or accident, or an infection that weakens the bone or joint structure.
Spondylolisthesis symptoms
Some people live with spondylolisthesis for many years and do not realize it until the slipped vertebra starts to affect nearby nerves. When this happens, discomfort can develop gradually and may worsen over time.
The most common symptoms include persistent lower back pain, often accompanied by discomfort or numbness in the legs. Some individuals experience symptoms including weakness in one or both legs, which can make standing, bending, or twisting particularly painful. In more advanced cases, walking or maintaining mobility becomes difficult.
Because these symptoms can overlap with other spinal conditions, it’s important to seek evaluation from a specialist if you experience ongoing back or leg pain.
Diagnosis
The spine surgeons at MedStar Health have extensive experience diagnosing all types of spondylolisthesis. Our initial exam generally includes:
- Medical history evaluation – This includes asking questions about when your pain began, and where the pain feels most severe. Other questions may be about whether you have other medical problems, and if you take any medications.
- Physical exam – Your surgeon will do a focused neurological exam on your spine.
- Imaging tests – Your surgeon may want to examine the bones and joints themselves using a variety of imaging techniques, including:
- X-ray, which will show if your bones are aging or if any of the vertebrae are out of alignment
- CT scan, which combines X-ray technology with computers to provide a very detailed picture of the spine
- MRI, which uses powerful magnets and computer technology to create a picture of your nerves and discs
Treatments
In most cases, our spine team will first try to treat the pain and discomfort with non-surgical techniques. Treatment options may include:
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Anti-inflammatory or pain medications
If non-surgical treatment does not relieve your symptoms, surgery may be necessary. The spine surgeons at MedStar Health have extensive training in advanced and innovative spondylolisthesis surgery options, including:
Our providers
Location: Change location Enter your location
Spine Surgery
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Evelyne S Akoth, MD PA
Spine Surgery & Neurosurgery
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Amjad Nasr Anaizi, MD
Skull Base Surgery, Spine Surgery, Neurosurgical Oncology, Neurosurgery, Vascular Neurosurgery & Brain and Tumor Neurosurgery
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Rocco Anthony Armonda, MD
Neurosurgery, Neurological Surgery & Spine Surgery
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Edward Fiore Aulisi, MD
Neurological Surgery, Neurosurgery & Spine Surgery
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Vinay R. Deshmukh, MD
Neurosurgery & Spine Surgery
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Zeena Dorai, MD
Spine Surgery & Neurosurgery
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Victor Xiaocong Du, MD
Spine Surgery & Neurosurgery
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Mark H Iguchi, MD
Neurosurgery & Spine Surgery
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Christopher Gene Kalhorn, MD
Spine Surgery & Neurosurgery
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Robert Bryan Mason, MD
Spine Surgery & Neurosurgery
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Kevin Michael McGrail, MD
Neurosurgery & Spine Surgery
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Susan Cecilia Moreno, MD PA
Spine Surgery & Neurosurgery
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Faheem Akram Sandhu, MD
Spine Surgery, Neurological Surgery & Neurosurgery
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Charles L. Schnee, MD
Neurosurgery & Spine Surgery
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Jugal Kaushik Shah, MD
Neurosurgery & Spine Surgery
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Rizwan Ahmad Tahir, MD
Spine Surgery, Neurosurgery & Interventional Neuroradiology
Show All Spine Surgery
Our locations
Distance from Change locationEnter your location
MedStar Health: Medical Center at Mitchellville
12158 Central Ave. Mitchellville, MD 20721
MedStar Health Orthopedics at McLean Beverly Road
1420 Beverly Road Ste. 210 McLean, VA 22102
202-444-7804
MedStar Health Neurosurgery at Vienna
8230 Boone Boulevard Ste. 360 Vienna, VA 22182
MedStar Health Neurosurgery at McLean Beverly Road
1420 Beverly Road Ste. 200 McLean, VA 22101
703-752-8069
MedStar Health Neurosurgery at Chevy Chase
5454 Wisconsin Ave. Ste. 1225 Chevy Chase, MD 20815
MedStar Health Neurosurgery at MedStar Washington Hospital Center Neuroscience Center
110 Irving St., NW Ste. G019 Washington, D.C., 20010
MedStar Health Neurosurgery at Ellicott City
9501 Old Annapolis Road Ste. 220 Ellicott City, MD 21042
MedStar Health Neurosurgery at Catonsville
4660 Wilkens Avenue Ste. 100 Baltimore, MD 21229
MedStar Health Neurosurgery at Pikesville
1838 Greene Tree Rd Ste.245 Pikesville, MD 21208
MedStar Health Neurosurgery at Timonium
2118 Greenspring Drive 2nd Fl. Timonium, MD 21093
MedStar Health Neurosurgery at MedStar Harbor Hospital
2900 S. Hanover St. 1st Floor Baltimore, MD 21225
MedStar Health Neurosurgery at MedStar Franklin Square Medical Center
9103 Franklin Square Dr. Suite 301 Rosedale, MD 21237
MedStar Health: Neuroscience at MedStar Georgetown University Hospital
3800 Reservoir Road, NW Pasquerilla Healthcare Center 7th Floor Washington, D.C., 20007
MedStar Health Neurosurgery at Annapolis Generals Highway
2114 Generals Highway Suite 101-B Annapolis, MD 21401
MedStar Health Neurosurgery at Bel Air
12 MedStar Blvd. Ste. 300 Bel Air, MD 21015
MedStar Health Neurosurgery at Westminster
412 Malcolm Drive Ste. 200 Westminster, MD 21157
MedStar Health Neurosurgery at Frederick
163 Thomas Johnson Drive Unit E Frederick, MD 21702
MedStar Health Neurosurgery at MedStar Montgomery Medical Center
18109 Prince Philip Dr. Ste. 300 Olney, MD 20832
MedStar Health Neurosurgery at Kent Island
1630 Main St. Ste. 208 Chester , MD 21619
MedStar Health: Spine Center at McLean
1420 Beverly Road Ste. 210 McLean, VA 22101
MedStar Health: Spine Center at Chevy Chase
5454 Wisconsin Ave. Barlow Bldg. 11th Floor Chevy Chase, MD 20815
301-215-4470
MedStar Health Spine Center at MedStar Union Memorial Hospital
3333 North Calvert St. Johnston Professional Building Ste. 655 Baltimore, MD 21218
MedStar Health Orthopedics at Westminster
412 Malcolm Dr. Ste. 200 Westminster, MD 21157
MedStar Health Orthopedics at MedStar Georgetown University Hospital
3800 Reservoir Road NW Washington, D.C., 20007
MedStar Health Orthopedics at MedStar Washington Hospital Center
106 Irving Street NW Physician's Office Building, North Ste. 5000 Washington, DC 20010
MedStar Health Orthopedics at Ellicott City
9501 Old Annapolis Road Dorsey Hall Medical Center Suite 220 Ellicott City, MD 21042
MedStar Health Orthopedics at Hunt Valley
2 Loveton Circle Sparks Glencoe, MD 21152
MedStar Health Orthopedics at Timonium
2118 Greenspring Dr. Timonium, MD 21093
MedStar Health Orthopedics at MedStar Harbor Hospital
2900 South Hanover St. Baltimore, MD 21225
MedStar Health Orthopedics at MedStar Franklin Square Medical Center Surgery Center
9101 Franklin Square Dr. Medical Arts Bldg. Ste. 200 Baltimore, MD 21237
MedStar Health Orthopedics at Perry Hall
5009 Honeygo Center Dr. Ste. 210 Perry Hall, MD 21128
MedStar Health Orthopedics at Annapolis Bestgate Road
810 Bestgate Rd. Suite 310 Annapolis, MD 21401
MedStar Health Orthopedics at Bel Air
12 MedStar Blvd. 3rd Floor Bel Air, MD 21015
MedStar Health Orthopedics at Brandywine
13950 Brandywine Road 2nd Floor Brandywine, MD 20613
MedStar Health Orthopedics at Leonardtown
23503 Hollywood Road Suite 101 Leonardtown, MD 20650
MedStar Health Orthopedics at Wheaton
11915 Georgia Ave. Wheaton, MD 20902
MedStar Health Orthopedics at Lafayette Centre
1120 20th St NW Building 1 South Washington, D.C., 20036
MedStar Health Orthopedics at Mitchellville
12158 Central Avenue Mitchellville, MD 20721
MedStar Health Orthopedics at Lorton
9455 Lorton Market Street Suite 200 Lorton, VA 22079
MedStar Southern Maryland Hospital Center
7503 Surratts Rd. Clinton, MD 20735
Patient resources
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Innovative Awake Spinal Surgery delivers a Fast, Pain-free Recovery
Frequently asked questions
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What are the different types of spondylolisthesis?
There are four main types of spondylolisthesis, based on the cause of the spinal slippage:
- Degenerative spondylolisthesis: The most common type. It develops over time due to age-related wear and tear on the spinal discs and joints.
- Congenital (isthmic) spondylolisthesis: Caused by a defect or stress fracture in the pars interarticularis, known as spondylolysis.
- Traumatic spondylolisthesis: Occurs after a sudden spinal injury, such as a fall or accident, that leads to a fracture and vertebral slippage.
- Pathologic spondylolisthesis: A rare type caused by tumors or spinal infections that weaken the vertebrae and supporting structures.
Degenerative and congenital types account for most cases of spondylolisthesis. A spine specialist can determine the specific type through a physical exam and imaging studies, which helps guide appropriate treatment options.
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How is spondylolisthesis graded?
Spondylolisthesis is graded on a scale from Grade 1 to Grade 4, based on how far one vertebra has slipped forward over the one below it:
- Grade 1: Mild slippage
- Grade 2: Moderate slippage
- Grade 3: Severe slippage
- Grade 4: Very severe slippage (rare)
The grade is determined by the percentage or distance of the vertebral slip, as seen on imaging studies. Higher grades indicate greater spinal instability and may influence treatment recommendations.
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What’s the difference between spondylolisthesis and spondylolysis?
The key difference is that spondylolysis is a cause, while spondylolisthesis is a result. Spondylolysis is a stress fracture or defect in a part of the vertebra called the pars interarticularis. It can be congenital or caused by repetitive stress or injury. Spondylolisthesis occurs when one vertebra slips forward over the one below it, often as a result of spondylolysis causing spinal instability.
Not everyone with spondylolysis develops spondylolisthesis, but over time, the stress fracture can allow vertebral movement and lead to slippage.
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Can spondylolisthesis heal on its own?
Symptoms from spondylolisthesis can often improve or resolve with non-surgical treatment. Many people experience significant relief through options such as physical therapy, activity modification, and other conservative treatments.
Non-operative care is often very successful at reducing pain and improving function, even though the spinal anatomy itself does not fully “heal.”
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When should I see a spine specialist for spondylolisthesis?
Anyone diagnosed with spondylolisthesis should consider seeing a spine specialist to review both non-surgical and surgical treatment options. A specialist can confirm the diagnosis, assess the severity of the slip, and recommend an appropriate treatment plan.
Most people with spondylolisthesis are treated successfully with non-operative care, such as physical therapy and injections, and may be able to avoid surgery for many years. See a specialist early to help manage symptoms and prevent unnecessary progression.