Treatment Options for Spondylolisthesis

Treatment of Spondylolysis

Patients with asymptomatic spondylolysis requires no treatment. Follow-up radiographic imaging should be performed every six months during skeletal growth to track the status of the defect.

Individuals with symptomatic spondylolysis may be managed conservatively without surgery including:

• Restriction of strenuous activity
• Short course of bedrest
• Mild analgesics
• A physical therapy program to increase and strengthen abdominal and spinal muscle tone
• Lifestyle modifications - including maintaining proper weight with diet and appropriate exercise and cessation of smoking
• Orthosis or brace to correct lordosis of lumbosacral area, to provide support, and to reduce pain

Most patients (estimates range between 65% and 80%) respond to this type of treatment with total resolution of symptoms. When the pain goes away, the individual can resume all activities including sports. Following severe pain, many physicians recommend waiting about 3 months before resuming activities. If pain is severe in a child, a bone scan can determine if there is a defect in the pars.