Can Spondylolisthesis Be Reversed?
Spondylolisthesis, a condition where one vertebra slips forward over another, is relatively common. But can it be reversed once it happens? At my practice, Nitin Khanna, MD, patients often ask if there are nonsurgical ways to realign the spine and eliminate painful spondylolisthesis symptoms. While mild slippage may remain stable or heal on its own, moderate to severe slips usually require surgery to correct.
What Is Spondylolisthesis?
Spondylolisthesis occurs when a vertebra, along with the section of the spine above it, slides forward over the bone beneath it. This causes the spine to become misaligned and the vertebral column to lose stability. In some cases, the displaced vertebra may also pinch nerve roots, leading to sciatica or numbness.
Several factors can cause spondylolisthesis, including:
Congenital defects in vertebral architecture.
Degenerative disc disease
Fractures
Repeated spine stress or injury
The slippage is graded based on how far the vertebra has moved out of alignment. Mild is a 25% slip, moderate is 50%, and severe is 75% or more.
Can Non-Surgical Treatments Reverse Spondylolisthesis?
For very mild slips of 25% or less, non-surgical treatments may help stabilize or reverse the condition. These include:
Physical therapy – Stretches and exercises can strengthen core and back muscles to support the spine.
Bracing – Custom rigid back braces limit spine movement and prevent further slips.
Anti-inflammatory medications – Over-the-counter NSAIDs reduce swelling and pain.
Steroid injections – Epidural injections deliver steroids around inflamed nerves.
Chiropractic adjustments – Manual manipulation attempts to reposition vertebrae.
However, conservative treatments are rarely enough to reverse slips of more than 25%. Moderate to severe spondylolisthesis almost always requires surgery to realign and fuse the unstable section of the spine.
When Surgery is Necessary to Correct Spondylolisthesis
For slips greater than 25%, surgery is usually needed to stabilize the spine and relieve painful spondylolisthesis symptoms. The goals of surgery are to:
Reposition the slipped vertebra to realign the spine.
Fuse the unstable spinal section using metal rods and screws.
Alleviate pinched nerve compression causing radiating leg pain.
The most common surgical treatment is spinal fusion. In this procedure, the surgeon accesses the spine from the back, repairs the slip, and secures the unstable vertebrae together using instrumentation. Over time, the fused bones heal into one solid segment. Successful fusions reduce the possibility of further slips in the future.
After surgery, most patients can resume their usual routines within a few months. Medications control post-op pain, physical therapy improves mobility, and activity modification allows the fusion mass to fully mature. Regular X-rays track healing progress and annual imaging checks for issues adjacent to the fused area.
While experts once feared fusions limited spine mobility or accelerated degeneration in nearby vertebrae, improved techniques now make complications rare for most patients.
For those with stubborn spondylolisthesis pain despite conservative measures, surgery can provide lasting relief and spine stabilization.
Conclusion: Can Severe Spondylolisthesis Be Reversed Without Surgery?
Mild spondylolisthesis slips of 25% or less may heal through physical therapy and bracing. However, moderate to severe vertebral displacement generally requires spinal fusion surgery to realign and stabilize the spine.
For painful, unstable spondylolisthesis causing poor quality of life, surgery often provides the greatest chance for long-term pain relief and lasting correction.
If you have been diagnosed with spondylolisthesis and have lingering back pain or sciatica symptoms, scheduling an appointment is important.
At Nitin Khanna, MD, we create customized treatment plans to reduce pain and regain stability, using both nonsurgical options and minimally invasive spine surgery when necessary. Our goal is to help patients live active, fulfilling lives free from chronic spondylolisthesis pain.
Contact our office today to discuss your options.