The spine is made up of small bones called vertebrae, which are stacked on top of one another. The bones connect to create a tube that protects the spinal cord. Spondylolysis is a common cause of low back pain in adolescents that is caused by a crack or stress fracture in one of the vertebrae. In some cases, stress fractures weaken the bone so much that it begins to shift or slip out of its place in the spine. This is known as spondylolisthesis.

Causes and Risk Factors

In children and adolescents, spondylolisthesis commonly occurs during periods of rapid growth (growth spurt). Spondylolisthesis is more likely to occur in young athletes who participate in sports that require frequent hyperextension of the lower spine, such as gymnastics, football, or weightlifting.


Common signs and symptoms of a vertebrae slippage include:

  • Back pain similar to muscle strain
  • Pain that radiates to the buttocks or back of the thighs
  • Pain worsens with activity and improves with rest
  • Back stiffness
  • Unusually tight hamstrings
  • Difficulty standing and walking
  • Tingling, numbness, or weakness in the legs


Patients with a mild spondylolisthesis will usually improve with conservative treatment. Nonsurgical treatment options include:

  • Rest from sports or other activities that place stress on the lower back
  • Anti-inflammatory medications to help reduce swelling and relieve pain
  • Physical therapy exercises to improve flexibility and strengthen muscles
  • Bracing to limit the movement of the spine and allow fractures to heal

More severe cases of spondylolisthesis or cases that are not improving with conservative treatment may require surgery. A spinal fusion is the most common surgical procedure used to treat spondylolisthesis.

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