Spondylosis is general age-related wear in the spine. It means disc degeneration, bone spurs and facet arthritis together. Spondylolisthesis is one vertebra (spine bone) slipped forward on the one below. It is graded 1 to 4 by how far it has slipped.
Two words that look alike but mean very different things.
What is the difference between spondylosis and spondylolisthesis?
- Spondylosis is a general term for age-related wear in the spine. It covers disc degeneration, bone spurs and facet arthritis together. It describes what is seen, and it is very common.
- Spondylolysis is a defect or stress fracture in one part of the vertebra (the pars interarticularis). It is often seen in young athletes.
- Spondylolisthesis is one vertebra having slipped forward on the one below. It is graded 1 to 4 by how far it has slipped.
Which is more serious, spondylosis or spondylolisthesis?
Spondylosis on a report is generally the equivalent of “wear and tear.” Spondylolisthesis is a more specific finding about the spine’s structure. Even so, a Grade 1 slip is often stable and causes no symptoms for decades.
Remember the general rule. Findings like this one are common in people with no pain at all. They become steadily more common with age. A finding on a report is not a diagnosis until someone has matched it to your symptoms and your exam. See understanding your MRI report.
Bring your scan and report in and we will go through it with you. Call us or request an appointment.
Does spondylosis or spondylolisthesis explain my back pain?
These two words are easy to mix up, and they mean different things. Spondylosis is general age-related degenerative change (the spine breaking down). That means disc height loss, bigger facet joints and bone spurs. Almost everyone has it past middle age. Spondylolisthesis is one vertebra sitting forward on the one below it. It is graded I to IV by how far it has slipped. A report can describe both at once. Neither finding by itself shows the cause of pain. What matters is two things. First, is a segment unstable? Flexion and extension views (X-rays taken bending forward and back) answer that. Second, is a nerve root being crowded? The exam answers that.
Frequently asked questions
Is a spondylolisthesis dangerous?
Low-grade slips are usually stable and managed conservatively, without surgery. It is watched closely if the slip gets worse or presses on a nerve.
Which one do I have?
Read the wording carefully. Spondylosis is degenerative change. Spondylolisthesis is a slip. Many reports mention both, and they mean different things for you.
Is a grade I slip serious?
Usually not. Low-grade slips are common and often stable for years. We manage them by your symptoms, not by the measurement.
Do I need flexion and extension views?
They are worth having when a slip has been reported and the question is whether it is unstable. That is because a single still image cannot show whether the segment moves.
Can I have both at once?
Often, yes. Degenerative spondylosis weakens the parts that hold the bones in place. That lets a degenerative slip develop. So reports that describe both together are common and expected. They do not contradict each other.
Can spondylolisthesis be treated without surgery?
Usually, yes, when the slip is low grade. Low-grade slips are common and often stay stable for years. We manage them by your symptoms, not by the measurement. The slip is watched more closely if it gets worse or starts crowding a nerve root. Flexion and extension views show whether a segment is unstable. The exam shows whether a nerve is involved.
How is spondylolisthesis diagnosed?
Imaging shows one vertebra sitting forward on the one below it. The report grades the slip from 1 to 4 by how far it has moved. A single still image cannot show whether the segment moves. So flexion and extension views are taken when the question is whether it is unstable. The exam then shows whether a nerve root is being crowded. The picture alone cannot tell you that.
How is spondylolysis different from spondylolisthesis?
Spondylolysis is a defect or stress fracture in one part of the vertebra, the pars interarticularis. It is often seen in young athletes. Spondylolisthesis is one vertebra slipped forward on the one below. Spondylosis, the third look-alike word, is general age-related wear. Read your report carefully, because the three words sound alike and mean different things.
Sources
- Bydon M et al. Degenerative Lumbar Spondylolisthesis: Definition, Natural History, Conservative Management, and Surgical Treatment. Neurosurgery clinics of North America, 2019. PubMed 31078230
- Brinjikji W et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR. American journal of neuroradiology, 2015. PubMed 25430861
- Mohile NV et al. Spondylolysis and Isthmic Spondylolisthesis: A Guide to Diagnosis and Management. Journal of the American Board of Family Medicine : JABFM, 2022. PubMed 36526328
- Fardon DF et al. Lumbar disc nomenclature: version 2.0: Recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology. The spine journal : official journal of the North American Spine Society, 2014. PubMed 24768732
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