Boise Spondylolisthesis Surgeon

What Is Spondylolisthesis?

Spondylolisthesis is a spinal condition in which one vertebra slips forward over the one below it. This misalignment can compress nerves or strain the supporting tissues of the spine. The slippage may be mild, moderate, or severe, and may happen in the neck (cervical spine) or, more commonly, in the lower back (lumbar spine).

When lumbar vertebrae slip, symptoms often include back pain, stiffness, numbness or tingling in the legs, muscle weakness, and in some cases difficulty walking or standing for long periods. Many patients also notice that symptoms worsen with standing, walking, or extending the back. Sometimes there are no symptoms at all, and the condition is discovered on imaging for another reason.

Spondylolisthesis has several causes: degenerative changes from aging, wear and tear of the spinal discs and joints; a defect or fracture in the pars interarticularis of the vertebra (pars defect); trauma; or in rare cases congenital (from birth). The risk tends to increase with age, repetitive stress on the spine, certain athletic activities, and sometimes poor spinal alignment or biomechanics.

Because symptoms vary so much, the decision to treat surgically depends on both imaging findings and how symptoms are affecting daily life. Dr. Kelly Bridges works closely with each patient to assess how much the slippage, nerve involvement, and symptoms are impacting mobility, comfort, and quality of life.

How It Develops and Why It Matters

Over time, small amounts of slippage can increase due to degeneration of discs and joints, and thickening of ligaments. As supporting structures weaken, the vertebra shifts slightly. In lumbar spondylolisthesis, this can narrow foramina (the openings where nerves exit) and press on nerve roots, causing pain, tingling, or numbness in the legs.

This matters because prolonged nerve compression can lead to progressive weakness or even permanent nerve changes if left untreated. In severe cases, the slippage can destabilize the spine, resulting in increased mechanical stress, further degeneration, and worsening symptoms such as sciatica, difficulty walking, or balance issues.

Imaging studies—like X-rays, MRI, or CT scans—show both the degree of slippage and whether there is nerve compression or other contributing factors. These studies help understand which vertebrae are involved, whether adjacent structures are under strain, and whether early intervention may prevent worsening.

Early recognition and appropriate treatment are key. Patients who seek evaluation before severe symptoms develop often have more treatment options, less risk of permanent damage, and potentially smoother recoveries.

Symptoms & Non-Surgical Treatment Options

Common symptoms include low back pain that may radiate to the buttocks or legs, stiffness in the lower back, pain that worsens with standing, walking, or bending, occasional “electric shock” sensations or tingling, and sometimes weakness. Pain may fluctuate depending on activity, rest, and posture.

Many people with mild or moderate spondylolisthesis manage quite well without surgery. Non-surgical treatments typically begin with physical therapy to strengthen core muscles, improve flexibility, and improve spinal alignment. Pain medications or anti-inflammatories can help reduce irritation of nerves. Injections may be used in some cases to reduce inflammation or relieve nerve irritation. Lifestyle changes—such as reducing activities that aggravate symptoms, modifying posture, losing weight if needed—also play an important role.

The goal of non-surgical care is to reduce pain, restore function, and delay or avoid surgery if possible. Dr. Bridges emphasizes giving these options a fair trial, carefully monitoring symptom progression. Many patients with spondylolisthesis find significant relief through these measures and are able to maintain active lives without requiring surgery

When Surgery May Be Necessary

If symptoms persist or worsen despite non-surgical treatments, surgery might become the best option. Surgery may be considered when:

• Leg pain, numbness, or weakness interferes with daily activities
• Walking becomes difficult, or balance is affected
• Bowel or bladder function is impaired (a serious situation)
• Imaging shows significant slippage, nerve compression, or spine instability contributing to declining function

Surgical options vary depending on the level and severity of slippage and the anatomy. Common procedures include a decompression (removing the bone or tissue pressing on the nerves), spinal fusion (stabilizing the vertebrae in the correct alignment), or both. The exact method depends on what will best restore alignment, relieve nerve pressure, and maintain as much natural movement as possible.

Dr. Bridges undertakes a thorough evaluation to ensure that surgery is recommended only when it is likely to offer meaningful improvement. If surgery is chosen, the plan is tailored to the patient’s health status, symptoms, and goals.