C O A S T A L

Treatment with Coastal Neurosurgery & Spine

Spondylolisthesis/Spondylolysis

Do you have intermittent or chronic back pain that radiates into the buttocks? This is a symptom of spondylolisthesis and spondylolysis. Both of these conditions occur when a vertebra in the lower back experiences a stress fracture. Our doctors at CNS provide spondylolisthesis and spondylolysis treatment options that are non-invasive and minimally invasive, and we only recommend surgery as a last resort.

Understanding Spondylolysis

Spondylolysis is a condition where a small crack forms in the pars interarticularis. The pars interarticularis - Pars interarticularis refers to a small segment of bone that joins the facet joints in the back of the spine. A defect in this portion of the spine leads to a condition called spondylolysis. is a very small portion of bone that connects the facet joints at the back of the spine. This type of crack usually develops in the L5 vertebra but can also sometimes occur in the L4 vertebra.

Understanding Spondylolisthesis

Spondylolisthesis can occur as a result of spondylolysis. When the stress-fractured vertebra slips forward over the lower vertebra, the condition is then diagnosed as spondylolisthesis and is either labeled as low or high-grade.


  • Low-Grade Spondylolisthesis
  • High-Grade Spondylolisthesis

Causes of Spondylolisthesis and Spondylolysis

Spondylolisthesis and spondylolysis are typically caused by overuse, and it’s more common in children and young adults, especially those who play sports that require a lot of overextending of the lower back, like gymnastics, football and soccer, than it is in older adults. However, these conditions can occur at any age and with any level of activity.


The second most common cause of Spondylolisthesis and spondylolysis is genetics. It some instances, it has been found that certain individuals may be born with thinner than average vertebral bones, which may be more susceptible to fracture and slippage.

Symptoms of Spondylolisthesis and Spondylolysis

For many individuals, spondylolisthesis and spondylolysis are asymptomatic, or the symptoms are so mild that they are not noticed. For these individuals, spondylolisthesis and spondylolysis may not be diagnosed until digital images are taken of the spine for a different type of injury, like a pinched nerve or suspected herniated disc. For individuals who do have symptoms, the pain may be mild or feel like a sprain or strain of the back. In some instances, the pain may radiate into the buttocks and worsen with prolonged activity. In time if left undetected and corrective measures taken then the symptoms can worsen greatly.

Spondylolisthesis and Spondylolysis Treatment Options with Coastal Neurosurgery & Spine

Here at CNS, we offer non-surgical, minimally invasive and surgical options for spondylolisthesis and spondylolysis. Our Providers that treat spondylolysis always strives to treat the condition with non-surgical and minimally invasive treatments before recommending surgery.

Non-Surgical Treatments

Non-surgical spondylolysis and spondylolisthesis treatment is always the first choice of our Providers in all cases.


  • Ice and Heat Therapy: Can help reduce inflammation and pain while promoting healing of soft tissues. Ice and heat can also be used when pain suddenly increases.
  • Pain Management: We offer individualized pain management program that utilizes over-the-counter and prescription medications as well as additional therapies and relaxation techniques to help reduce your pain and improve your quality of life.
  • Strengthening Exercises: Strengthening the back and core muscles can help alleviate pain and help better support the spine, which helps reduce pain.
  • Physical Therapy: Physical therapy is great for restoring function and mobility to injured parts of the body, including the back. This treatment involves performing extremely targeted exercises, movements and stretches both at home and in our office.

Minimally Invasive Treatments and Surgical Options

Out minimally invasive spondylolisthesis treatment options and surgical options are designed to help alleviate your pain so that you can get back to doing the activities you love. Our Providers typically recommend surgery as a last resort.


  • Radiofrequency Ablation: Helps reduce pain by targeting the aggravated nerve and preventing it from sending pain signals to the brain. During this treatment, a needle is guided to the nerve with the help of x-rays. Then, radiofrequency waves are passed through to the needle. As the temperature of the needle decreases, a small lesion is created on the nerve to stop the pain signals.
  • Steroid Injections: Steroid injections or pain management injections (aka ESI’s) are delivered directly to the spine in order to help control pain and restore mobility while other non-invasive treatment options, like chiropractic adjustments and physical therapy, are continued.
  • Spinal Fusion: This spondylolysis surgery involves placing bone grafts around the damaged vertebra in order to fuse it to the next to it. This can help stabilize the lower spine and provide pain relief.
  • Minimally Invasive Spondylolisthesis Surgery: has fewer risks and faster recovery times than traditional back surgery options. Our spondylolisthesis doctor can use minimally invasive techniques to provide disc decompression, fuse vertebrae and alleviate pressure on the spinal cord.
  • Neurosurgery: Can help unpinch nerves and increase the stability of the spine in order to help reduce pain and restore your mobility. Our surgeons typically recommends back surgery as a last resort
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