What is Spondylolisthesis?

Spondylolisthesis is a condition that is commonly called a slipped vertebra. Due to a genetic proclivity or some trauma such as a car accident, one of the vertebra slip out of place over the vertebra below it. A slipped vertebra can occur anywhere along your spine but is most commonly found in the middle of the lumbar spine.

Spondylolisthesis is not the same as a slipped disc. To understand the difference, it will help to review the anatomy of the spine. The top three regions of the spine, the neck (cervical), mid-back (thoracic) and lower-back (lumbar) contain 24 vertebrae. Between each vertebra, there is an intervertebral disc which serves as a shock absorber. In total there are 23 intervertebral discs which are made of firm tissue, not bone. Intervertebral discs will herniate; bones will break and chip.

One way to recall the meaning of the word spondylolisthesis is to remember that ‘spondylos’ means vertebra in Greek; ‘olisthanein’ means to slip. Combine the two, and you have a slipped vertebra.

What are the five types of spondylolisthesis?
  1. Degenerative: Caused by degenerative changes in the spine usually involving destabilization caused by facet joint and disc degeneration which leads to a vertebra slipping
  2. Isthmic: Microtrauma that occurs in adolescence as the result of athletics
  3. Traumatic: Occurs after a fracture of the pars interarticularis or facet joint structures due to a trauma such as a car accident.
  4. Dysplastic: Congenital condition often with the abnormal alignment of facet joints
  5. Pathologic: Related to systemic causes such as bone and connective tissue disorders, infections or tumors.
How do you treat spondylolisthesis?
  1. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAID) such as aspirin, naproxen and ibuprofen will reduce pain and inflammation.
  2. Physical therapy that focuses on posture, range-of-motion and joint flexibility will help build strength and reduce pain.
  3. Yoga, Pilates and Tai Chi may also help the patient improve mobility, reduce stress and enhance the immune system.
  4. Back brace provides support for the lumbar region
What are the symptoms of spondylolisthesis?
  • Pain in the lower spine
  • Leg stiffness
  • Pain in thigh
  • Tight hamstring
  • Pain in buttocks
What if the nonsurgical treatments do not relieve the pain of spondylolisthesis?
Some patients may not respond to conservative therapy and may require surgery. For patients with severe pain due to the degree of slippage of the vertebra, surgery may be the optimal treatment. Dr. Nourian may request additional imaging tests of the disc lesion using X-rays and MRIs. He will review the results with you and discuss the best option. For most patients who suffer from a severely slipped vertebra, the best surgical option may be a spinal fusion.

Modern spinal fusion operations are minimally invasive. The required incisions are small which leads to lower risks of infection, decreased bleeding and reduced back muscle discomfort. Dr. Nourian’s minimally invasive surgeries are opioid-free during the operation and through recovery. As a result, the risk of unwanted opioid addiction is significantly reduced.

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What Patients Think About Dr. Nourian

Awesome awesome doctor!!!very nice to all his patient! Dr. Nourian is very kind and caring. A very pleasant man and easy to communicate with. He saw my son when he injured his hip and He took extra good care of him. After 2 wks he was able to resume sports. He’s not only a very good orthopedic surgeon but also an amazing Spine doctor. He always make sure he always gets the job done. 2 Thumbs up to this Doctor!!!??

Regz Ramos


Dr. Nourian was fantastic! He was able to alleviate my back pain. I would recommend him to anyone

Nikesh Patel


Dr. Nourian is the best. His bedside manner is friendly and professional and his staff is excellent. I went to see him after a terrible whiplash injury when I rear-ended while driving. After receiving my MRI results, the doctor was quick to reach out and went over my options with me. He really cares about his patients.

Michelle Sadighpour Shophet


Dr. Nourian is an outstanding physician. I injured my back while exercising recently. I went to see him, and he explained my injury to me in detail. He told me that my injury would most likely heal without surgery, but if I needed surgery in the future he would get me through it. He is honest, intelligent, and forthcoming. I am thankful for him as my spine physician.

Michael Broukhim


Dr. Nourian was absolutely fantastic. I was struggling with intense lower back pain. He took his time 40 minutes to be exact to see me and review everything with me after another follow up we decided to do surgery. Thank god!!! I’m back to working out, picking up my child, and living my best life. I was so hesitant to do surgery but he was a true god send. He would call me weekly to see how I’m doing.

Sara Sadig


Dr. Nourian is smart, caring, attentive and super knowledgeable. I highly recommend him as an orthopedic surgeon!

Sharon Darouvar Greiner


Great with patients and consciences of patient’s time as well as needs. He will spend time to assure the patients with respect to treatment plan and follow-up was amazing with my auntie’s back issues.

Connie Esparza


An extremely knowledgeable doctor with wonderful bedside manner. He clearly explained every step of the procedure and eased all my worries. My back is feeling great thanks to Doctor Nourian

Ashley Sadig


After seeing three doctors and all of them saying I should operate Dr Nourian was able to address and issue without and surgery. I got an epidural and did physical therapy and I’m able to run around with my grand child. He’s truly a gem. Everyone at the office was friendly and supportive.

Katrin Sadighpour


Dr. Nurian explained everything very well and preformed the surgery exactly as planned. I woke up pain free and the surgery pain was gone in five days. Could not give him enough praise.

Wade Savage