What Is Spondylolisthesis / Spondylolysis? (part 2)

spondylolisthesis

In part 1 of our spondylolisthesis and spondylolysis blog post we discussed the importance of knowing your body along with understanding the condition that you suffer from.

Proper knowledge and understanding of your spondylolisthesis or spondylolysis is critical for a successful, long-term recovery.

With that being said, let’s continue where we left off from part 1 and start this post with a very common question…… What is the difference between spondylolisthesis and spondylolysis?

Spondylolisthesis and Spondylolysis…Whats the difference?

If you have yet to get an exact diagnosis for your back pain, we highly recomend you seek professional medical advice.

To determine the exact problem of any back injury, an MRI is needed along with several X-Rays. Again, please seek a medical professional before you jump to any conclusions about your back condition.

Just because you have similar symptoms to those listed on websites, does not mean you actually have the condition. Without knowing exactly what you have, you will be playing the guessing game and the guessing game never turns out well.

Now, let’s get down to business…..

Spondylol – ysis

Over time, or in some cases during one specific event, stress is applied to the vertabrae. At some point the amount of stress cannot be tolerated and one (or more) of the bony projections of the vertabrae (pars interarticularis) will suffer a break.

spondylolysis fracture -jpeg

Illustration of a spondylolysis by Don Fuhrmann

Once this break occurs it is labeled as a spondylolysis. The most common type of spondylolysis is an isthmic spondylolysis.

Isthmic spondy’s are usually the result of frequent strain to this small area of the spine.  The illustration above shows the break from a side angle.

If you take a close look you can see the fracture located near the middle of the drawing on the pars interarticularis (The break is hard to see, but it is located on the third boney projection on the right hand side)  . This particular drawing has no slippage. Therefore this case would be labeled as a spondylolysis.

Spondylo – listhesis

The easiest way to differentiate between a spondylolysis and spondylolisthesis is to remember the word “slip”.

The main difference between these two often confused terms is the fact that with a spondylolisthesis slippage or a displacement is involved.

The slippage could be due to instability or breaks on both sides of the pars (bi lateral) or it could be due to some degenerative issues. The illustration below shows the break with slippage of the vertabrae, also known as a spondylolisthesis.

spondylolisthesis displacement

Illustration of spondylolisthesis displacement by Don Fuhrmann

Pay close attention to the two photos. You can see the break is in the same position as the previous photo, except in this photo the vertabrae on the left has slipped foward.

This type of slippage can lead to nerve pain and extreme muscle tightness. Due to the displacement or slippage, this case would be labeled a spondylolisthesis.

Conclusion

This is a short, simple, and easy way to remember the difference between these very similar sounding conditions.

After reading and thinking about these last two blog post you should have a basic understanding of the anatomy involved with these conditions. Although this is a very basic and brief explination, it should provide you with enough knowledge to explain and understand your condition.

Let us know if you have any questions or comments. Simply add a comment below in the comment section. If you have any friends or family members that may benifet from this information please pass it along by using some of the options in the share box below.

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Leave A Reply (25 comments so far)


  1. Amelia Bolton
    3 years ago

    was hoping you would show the difference in the different grades.


    • SpondyInfo
      3 years ago

      Hi Amelia,

      Thanks for the suggestion. The difference in grades is determined by a doctor using your test results. They take your test results and measure the the amount of slippage between the vertebrae that are affected by the break. A majority of time this is the measurement of how much the vertebral body has slipped over the body below it. I do not have access to spondy patients MRI’s to show photos of the different grades. And with the strict medical laws in combination with the privacy laws I do not feel comfortable posting MRI’s that do not belong to me on our website. You make a great suggestion and it would be very helpful to view the difference in grades. My recommendation would be to simply google “grade 1 spondylolisthesis MRI” and “grade 2 spondylolisthesis MRI” to view the difference. Without the measurement help of a doctor it is very hard to determine the slippage amount by naked eye. Here a link I ran across that shows the difference of the slippage in percentages: http://radiopaedia.org/articles/spondylolisthesis-grading-system
      I hope it helps…Thanks again for the suggestion and comment!


  2. Pam
    3 years ago

    I’ve been diagnosed with spondylolisthesis grade 2/3. I have no pain or numbness in my legs, but I do have some pain in my lower back. My doctors always seem to suggest surgery… personally I think they are “cut happy”. I am seeing an acupuncturist and a massage therapist for the past 1 1/2 years and it seems to help some. I also use the tens unit and a jacuzzi when in pain (not together lol). Can you tell me some exercises to do to strengthen my core without jeopardizing my condition.


    • SpondyInfo
      3 years ago

      Hi Pam.

      Its good to hear you are not having any pain or numbness in your legs and that acupuncture and massage provide some help. It is also nice that you have found some relief for pain in the form of tens and a jacuzzi (smart move not to use the together…lol!).

      There is so much more that goes into finding the right spondy exercises for you than just throwing a few simple ab exercises your way. There are so many variables and characteristics that make each spondy patient unique. What exercises work for me and someone else may or could actually cause more pain or harm to your spondy. To understand this concept more I encourage you to read this article: https://spondyinfo.com/10-things-that-make-your-spondy-unique/

      It will provide you with some insight on why it is so hard for me to answer your spondy exercise question. I also encourage you to download and read our free ebook.

      Once you have some time and can read this post and our Ebook, feel free to get back to me with any further questions.


  3. fred loewebaum
    3 years ago

    Hi
    I have a grade 1 spondylothesis. Have had it for many years. When flare ups occur they are
    ( as you and many suffers know) terrible. When not in a flare up period my back is almost constantly irritated. What can I do to keep my back stable. I walk, exercise eat properly but
    I feel like I’m playing russian roulette.. never knowing when my back will go out. When it goes out
    it feels like the lower half of my body isn’t attached to the top.
    When I was working and my children were younger this was major stress. I feel like I’ve missed out on a good portion of my life.
    I am 60 years old now and have 2 grandchildren. I would like to enjoy them to the fullest extent.
    Please if you know something i don’t can you share it.
    Sincerely
    Fred


    • SpondyInfo
      3 years ago

      Hi Fred and welcome to the site! I hope you find our information both helpful and practical. I understand your frustration and pain along with your russian roulette comment. Sometimes it can almost feel like a ticking time-bomb.

      You may feel like you have missed out on some opportunity, but it sounds like you are active, healthy and have a ton of opportunity remaining. First of all I encourage you – if you haven not done so already – download our beginner’s guide. It contains a ton of great info and will help you better understand our philosophy and approach.

      Second of all, it sounds like you are taking some great steps in maintain a healthy lifestyle which is a great thing. However, the one thing you may need to look more into to really help your spondy is getting some kind of full body movement screen or assessment to address your movement. This is a topic we discuss on our site often and we firmly believe plays a MAJOR role in providing individuals with the best chances of improving upon how they feel. Please read this blog post to gain a better understanding of this concept. Then, if you have any more questions, feel free to comment and we can go from there. Thanks for finding us Fred and best of luck….enjoy those grandkids!


  4. Gray Laney
    3 years ago

    Is congenital spondylolisthesis due to a break in the pars interarticularis?


    • SpondyInfo
      3 years ago

      Hi Gray. Congenital spondy’s are usually due to some deformation of the pars that make it more vulnerable to a break. Usually the break occurs over time and slippage follows, thus making it a spondylolisthesis.

  5. The doctor requested me to have to have ex-ray. It was found out that I have spondylolisthesis. The doctor then advice me to have an MIR which is to be done next week. I searched in the website what is the meaning of spondylolisthesis. I have already access to 3 THINGS EVERY PATIENT NEEDS TO KNOW. By reading this, I understand what is spondylolisthesis. As of now, I do not know what is the specific exercise needs for me because I waited until the result of the MRI and the instruction of my doctor.

    Thank so much for the information and knowledge I learned about spondylolisthesis. I expect to hear from you soon.

    Thank you and GOD BLESS YOU.


    • SpondyInfo
      2 years ago

      Hi Ludivina. Thanks for finding the site and I am glad the information has been of help. It sounds like you are on the right path. Speak to your doc and discuss your results to take the next step in your recovery process. Best of luck!


  6. Jad Wahab
    2 years ago

    I was diagnosed with bilateral L5 spondylolysis and I just wanted to make sure that I understood the article correctly. Can my spondylolysis lead to spondylolisthesis if slippage occurs, or is spondylolisthesis a completely different defect? Also is spondylolysis classified using grades like spondylolisthesis?


    • SpondyInfo
      2 years ago

      Hi Jad. Thanks for the question. If you were diagnosed with a spondylolysis it basically means you have a fracture in a certain portion of a vertebrae. If this fracture or break begins to slip in comparison to the vertabrae around it, it can become a spondylolisthesis. This is most common in individuals with bi-lateral spondylolysis. Over time, without taking appropriate measures, the break can slip and lead to spondylolisthesis (that is why early diagnosis is so important).

      In a nutshell spondylolysis means break and spondylolisthesis means break + slippage. That is a simple way to remember it and of course there are rare exceptions but this applies to most.

      Only spondylolisthesis is measured in grades. They are measured by the amount of slippage in one vertebrae compared to another. Since there is no slippage in a spondylolysis, there is nothing to measure – it is simply a fracture. There are various types of kinds of spondy’s and these are usually determined by your doctor and your health history. However, these are not grades, they are the kind of spondy or often the cause of your spondy. For example a isthmic spondy is the most common type and is often caused by an acute fracture or stress fracture. I hope this info makes it clear, and I agree, it is confusing!


  7. Jad Wahab
    2 years ago

    Thanks for the reply Justin. I just have one more question. Since I have spondylolysis, when reading the spondy improvement path, is there anything I should pay closer attention to or do differently?


    • SpondyInfo
      2 years ago

      No problem Jad. When we created the Spondy Improvement Path we wanted it to help both Spondylolithesis and Spondylolysis patients (this is why we always refer to them collectively as “spondy”). So there is nothing specific you need to do differently.

      You are already ahead of the curve to be honest, because many do not know exactly what they have. Sometimes doctors do not even go into detail with their patients and provide them with the information that helps them understand the difference! The information that will help you the most is the step that is dedicated towards educating you and guiding you on how to find therapy that is right for your situation. This will help you to fully understand how to go about finding a therapist that will put you in a good position to improve how you move and hopefully how you feel as well. We are big believers in addressing your movement and doing so with someone who treats their patients on a case by case basis. We explain how to go about this and it is important for both spondylolysis and spondylolisthesis sufferers. Thanks again for finding the site and best of luck!


  8. Gaynor Laight
    1 year ago

    Thank you for a great site. I live in the UK and have spondylolisthesis for about 18 months. I have terrific pain at the top of my legs and it makes it quite difficult to walk. I take Pregablin and exercise and go to hydrotherapy once a week and I also swim twice a week. Nothing seems to help and I really do not get much support – I find it very frustrating. I was told I would have an MRI, then told no but I would see the pain management term – that was three weeks ago! And now my doctor says he will try again to arrange an MRI for me.

    This is why your site is so helpful. Keep up the good work.


    • SpondyInfo
      1 year ago

      Hi Gaynor. Thanks for sharing your story. I know it can be frustrating, so do your best to hang in there. If you keep getting the run around from your current doctor, it may be time to consider searching for a second opinion. Best of luck!


  9. Patricia
    8 months ago

    Hi, I have been diagnosed with spondylolisthesis recently, L5/S1, grade 1. My latest flare-up has been going on for more than 2 months now, although it’s getting better with physical therapy and Pilates. I am also experiencing upper back and mid back stiffness and ache, to the point that sometimes it affects my breathing. Would you have an explanation? Does anyone have similar symptoms? I am 45, and have been doing sports most of my life. Thank you.


    • SpondyInfo
      8 months ago

      Hi Patricia. It’s a good sign that you are improving, so take this as a positive and keep moving forward. As far as your upper back stiffness and aches go, yes this can and does happen. There are several reasons this may occur, so it is hard for me to say for sure since I know nothing about your situation (besides that you have a spondy). This such as your movement mechanics, past injury history, etc all play a vital role in determining an exact answer. Common reasons are faulty breathing patterns and adjustments or compensations made by the body in an effort to reduce the stress or strain on your low back. I would bring this new discomfort up in a conversation with your therapist and pilates instructor. Since they know you and your body, hopefully they can provide some feedback. Also, make sure to read around the blog here for more information to help you better understand your condition and body. There are some great questions and feedback in the comment sections that may provide further help. Thanks for finding us and best of luck!


  10. Saïd Mesbahi
    6 months ago

    I was diagnosed with Spondylolysis, bilateral at the L5, a year ago at 14. I rested the back for three months and went back to competitive soccer. After several months of playing pain-free, the pain’s returned. CT scan shows unilateral Spondylylosis L5S1. The orthopedist says the defect is permanent, and the pain is because of inflammation. He says there’s sclerosis and that the injury is not likely to get worse. He doesn’t advise quitting soccer but cannot tell me how I can continue to play competitively without pain. Any advice?


  11. Rebecca
    6 months ago

    Hi Jason

    When you talk about pars… is it the same as facet?


    • SpondyInfo
      6 months ago

      Hi Rebecca. In short..no. The facet joints are the basically the part of your spine that help to make your back flexible and allow you to move (bend, twist, etc.). Pars on the other hand are small pieces of bone that join the facet joints in the back of the spine.


  12. Rebecca
    6 months ago

    Hi *Justin, not Jason… 😊

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