Anterolisthesis: Symptoms, causes, and treatment

Anterolisthesis is an abnormal alignment of bones in the spine and usually affects the lower back.

It occurs when an upper vertebra slips in front of the one below. Pain is often the first symptom of anterolisthesis.

Misaligned vertebrae can pinch the nerves, and this can have painful and debilitating consequences. Other parts of the body, such as the arms or the legs, can also be affected by anterolisthesis.

The amount of slippage is graded on a scale from mild to severe. Treatment can range from bed rest to surgery. Anterolisthesis is often known as spondylolisthesis.

Contents of this article:

  1. Causes
  2. Symptoms
  3. Diagnosis
  4. Treatment
  5. Risk factors
  6. Outlook

Anterolisthesis may be caused by a sudden blunt force or may be caused by strenuous physical exercise over time.

Anterolisthesis is often due to sudden blunt force or fractures. These can be the result of trauma typically experienced in an auto accident or a fall. Anterolisthesis can also develop over time through strenuous physical exercise, such as bodybuilding.

Aging is another common cause of anterolisthesis. This occurs naturally over time as the cartilage between the vertebrae weakens and thins.

Anterolisthesis can also be linked to underlying conditions such as weak bones, arthritis, or tumors. A tumor can force the vertebra to move from its natural position.

Occasionally, anterolisthesis is linked to a genetic spinal growth defect in children.


The symptoms of anterolisthesis will depend on the amount of slippage and the part of the spine where the slippage occurred.

Anterolisthesis can cause constant and severe localized pain, or it can develop and worsen over time. Pain may be persistent and often affects the lower back or the legs.

Mobility issues due to pain can lead to inactivity and weight gain. It can also result in loss of bone density and muscle strength. Flexibility in other areas of the body may also be affected.

Other symptoms of anterolisthesis include:

  • muscle spasms
  • pulsating or tingling sensations
  • inability to feel hot or cold sensations
  • pain and poor posture
  • weakness

In severe cases, the following symptoms may occur:

  • difficulty walking and limited body movement
  • loss of bladder or bowel function

Suspected anterolisthesis may be diagnosed using X-rays, CT scans or MRI scans.

A doctor will diagnose anterolisthesis using a physical examination and an evaluation of the person’s symptoms. The examination will usually include a reflex check.

X-rays, CT scans, and MRI scans may be used to confirm a suspected anterolisthesis diagnosis. These imaging techniques are used to examine bone defects, and to assess injuries and nerve damage.


The next step after diagnosis is to establish the extent of the damage. The following grading scale is used to determine the severity of the condition and what treatment is required.

  • Grade 1: less than 25 percent slippage
  • Grade 2: 26 to 50 percent slippage
  • Grade 3: 51 to 75 percent slippage
  • Grade 4: 76 percent or more slippage

There are rare cases of 100 percent slippage when the upper vertebra completely slips off the one below.


Doctors base a treatment plan on the grade of slippage. People with grade 1 and 2 slippages usually have mild symptoms, and the treatment aims to alleviate pain and discomfort. Grade 3 and 4 slippages are considered severe and may ultimately require surgery.

Treatment options for mild slippage may include a short course of bed rest, gentle exercise, and pain medication. Severe cases may require chiropractic therapy and surgery. Surgery is considered a last resort.


Bed rest can help overcome mild cases of anterolisthesis. Participation in sports and strenuous daily activities should be stopped completely until the pain subsides.

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