Degenerative Spondylolisthesis vs. Isthmic Spondylolisthesis

In spondy­lolis­the­sis, one ver­te­bral body slides for­ward rel­a­tive to its neigh­bor to the south.  There can be sev­er­al dif­fer­ent caus­es of this.  The two most com­mon types of spondy­lolis­the­sis are isth­mic spondy­lolis­the­sis and degen­er­a­tive spondy­lolis­the­sis.

Here are some of the major dif­fer­ences:

Isthmic spondylolisthesis

  • Orig­i­nal­ly occurs in a young per­son (age 5 through ado­les­cence)
  • Due to a stress frac­ture of part of the ver­te­bra known as the “isth­mus” or “pars inter­ar­tic­u­laris”
  • Often­times is asymp­to­matic, though over time the con­di­tion can progress and cause pain, move­ment lim­i­ta­tion, or neu­ro­log­i­cal com­pro­mise.
  • Most com­mon at the L5-S1 lev­el

Degenerative spondylolisthesis

  • Occurs in a per­son over 60
  • Due to long term degen­er­a­tion of the spinal joints
  • Can be asymp­to­matic, but it can cause pain and oth­er symp­toms.  May be hard to tell if the symp­toms are from the spondy­lolis­the­sis itself or are due to the gen­er­al degen­er­a­tion of the spinal joints
  • Most com­mon at L3-L4 or L4-L5.


Deepen Your Body of Knowledge

Doc­tors’ Guide to Spondy­lolis­the­sis




About Ronald Lavine, D.C.

Dr. Lavine has more than thirty five years' experience helping patients alleviate pain and restore health using diverse, scientifically-based manual therapy and therapeutic exercise and alignment methods. His website,, provides more information about his approach. Please contact him at or at 212-400-9663.
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