What is Spondylolisthesis?
Spondylolisthesis occurs when one vertebra slips forward relative to the vertebra below it, from a stress fracture, degenerative change, or a defect in the bony ring. The slip can narrow the canal and compress nerves, producing back pain, leg pain, and hamstring tightness.
Low-grade slips are usually managed with therapy and activity modification. Progressive or symptomatic slips may warrant a decompression and stabilization procedure, which Dr. Varma performs using the least invasive approach appropriate for the degree of slip and the patient’s anatomy.
Common symptoms
Why it happens
A vertebra slips forward either through a stress fracture of its bony ring (isthmic — often from adolescence) or through degenerative wear of the discs and facet joints (degenerative — typically after 50, most often at L4-5). The slip narrows the canal and can stretch the exiting nerves.
How it is diagnosed
Standing and flexion-extension X-rays measure the slip and — critically — whether it moves, which defines instability. MRI shows the nerve compression. Slips are graded I–IV by how far the vertebra has advanced.
Treatment options
Low-grade, stable slips are managed with core strengthening and activity modification. Progressive, unstable, or neurologically symptomatic slips warrant decompression with stabilization — which Dr. Varma performs through minimally invasive approaches (including ALIF) chosen to match the slip’s grade and level.
