Spondylolisthesis | Spondylolysis | Spondylisis | A problem of disc degeneration or ligament degeneration?

Spondylolisthesis | Spondylolysis | Spondylisis Fusion Alternatives

Ross Hauser, MD

When an injury, degenerative disc disease, or spinal ligament weakness causes spinal instability to the extent that the vertebrae are unable to maintain their proper position, a vertebra can slip out of place. This can occur on a single level or on multilevels of the spine.

The condition of “slipped disc” or “slipped vertebra,” is called by various names and diagnosis labels including degenerative Spondylolisthesis or under the more general term degenerative disc disease.

For the young athlete diagnosed with this condition please see spondylolisthesis in the athlete.

Many other terms for Spondylolisthesis: What does spondylosis and spondylitis mean?

Other terms are often used to describe the same symptoms of Spondylolisthesis. These are Spondylisis or spondylosis of the spine, what do they mean?

These are sometimes confusing terms that act as a catch all phrase or umbrella term to describe neurological or degenerative or inflammatory disorders caused by spinal defects which can occur in the cervical, thoracic, and lumbar regions. Spinal defects meaning stress fractures from wear and tear. This can also be called isthmic spondylolisthesis – a fracture of the pars interarticularis; a bone which connects the upper and lower facet joints.

The terms can also be linked to degrees of severity such as mild or moderate or advanced spondylisis or severe spondylisis that can cause local or diffuse pain. Sometimes everything is just thrown into one term spondylotic. It is sometimes difficult for the to understand all these definitions.

One problem is when the problem is difficult to understand – patients opt for surgery.


Spondylolisthesis grading

http://radiopaedia.org- http://goo.gl/9vBeCz

Spondyloliosthesis grading is based on amount of “slippage.” Slippage can also tell us how weak the spinal ligaments are.

It should be noted that Spondylolisthesis, Spondylolysis, and Spondylisis all have their origins with ligament injury. Ligaments are the connective tissue that hold the vertebrae in place. When you have slippage, it is because the strong band of ligaments are no longer strong enough to hold the vertebrae is place. Generally speaking, the more slippage the weaker the connective tissue. Strengthening the connective tissue

Typically grades 1 and 2 are treated successfully with Prolotherapy injections see below.


Prolotherapy for spondylolisthesis – treating the supporting ligaments before development of significant bone spurs.


Understanding how to determine and even treat or prevent worsening spondyloarthritis is discussed by Italy’s University of Foggia Medical School researchers. In their study in the Annals of Medicine the Italian researchers say: Despite intensive research into what causes slipped discs, some important questions still remain unanswered, particularly concerning formation of bone spurs in the spine.

Several studies suggest that spondyloarthritis pathogenesis prevalently occurs by endochondral ossification (a process of bone growth involving the cartilage), however it remains to identify factors that can induce and influence its initiation and progression.

The researchers end their paper bay saying: Complete understanding of spondyloarthritis pathophysiology requires insights into inflammation, bone destruction and bone formation, which are all located in entheses and lead all together to ankylosis (fusion) and functional disability.(1)

Comprehensive Prolotherapy which includes the use of stem cell therapy can be an ideal treatment for patient with developing spondylolisthesis because it strengthens the ligaments and tendon enthesis surrounding and attached to the slipped vertebrae. As the ligaments and tendons are strengthened spinal stability is restored.

Treatments are given to the ligaments on the back of the spine.  By tightening the ligaments in the back of the spine Prolotherapy helps stabilize the area thereby giving pain relief and allowing for other structures to heal. Typically a patient will require 3-6 visits, although some patients require more visits depending on their overall health status and the extent of their injury.

1. Neve A, Maruotti N, Corrado A, Cantatore FP. Pathogenesis of ligaments ossification in spondyloarthritis: insights and doubts. Ann Med. 2017 May;49(3):196-205. [Pubmed]

2. Scheepers MS, Streak Gomersall J, Munn Z. The effectiveness of surgical versus conservative treatment for symptomatic unilateral spondylolysis of the lumbar spine in athletes: a systematic review. JBI Database System Rev Implement Rep. 2015 Apr 17;13(3):137-73. doi: 10.11124/jbisrir-2015-1926 [Pubmed]

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