Degenerative spondylolisthesis

Every level of the spine is composed of a disc in the front and paired facet joints in the back. The disc acts as a shock absorber in between the vertebrae, whereas the paired facet joints provide further stability and limit certain motions. They allow the spine to bend forwards (flexion) and backwards (extension) but do not allow for a lot of rotation. As the facet joints age, they can become incompetent and allow too much flexion, allowing one vertebral body to slip forward on the other. This slippage is known as a degenerative spondylolisthesis, which is Latin for “slipped vertebral body.”

Degenerative spondylolisthesis is far more common in individuals older than 65 and is more common in females than males by a 3:1 margin. It is most common at the L4-L5 level of the lower spine, but can also happen at L3-L4. It is relatively rare at the other levels. It may also at multiple levels of the spine.

Symptoms

With degenerative changes of the spine (enlargement of facet joint and thickening of ligaments), narrowing of the spine can result in spinal stenosis. The symptoms of a degenerative spondylolisthesis are very similar to that of spinal stenosis. Patients usually complain of pain or a tired feeling down the legs when they stand for a prolonged period of time or try to walk any distance (pseudoclaudication). Generally, they do not have a lot of pain while sitting, because in the sitting position the spinal canal is more open. In the up