Understanding Spondyloptosis Animation

Spondyloptosis is a rare spinal condition in which one vertebra completely slips off the one below it.

This video will show you…
The anatomy of spondyloptosis, Common causes, Symptoms, Potential risks, and Treatment options

Spondyloptosis happens when a vertebra in the lower back completely slips forward and off the vertebra below it. The most common site for this to happen when the L5 vertebra slips completely off the S1 vertebra beneath it.

Think of your spine as a stack of building blocks.

In spondyloptosis, one lumbar block shifts so far that it no longer rests on the block below, causing instability and several potential risks and complications.

Usually, spondyloptosis is a progression of a condition called spondylolisthesis.

The most common cause of spondyloptosis is progression of a condition called isthmic spondylolisthesis that has progressed, usually at the L5-S1 level, until the L5 vertebra has completely slipped over the S1 vertebra.

In isthmic cases, the pars interarticularis - a pair of bones that connects the upper and lower joints of the vertebrae - fractures on both sides.

This fracture may make the spinal motion segment unstable, and in rare cases allows the upper vertebra to slide forward over time until it may ultimately slip completely off the vertebra below it.

The slipping often starts as a lower-grade spondylolisthesis and can worsen over time if instability and shearing forces continue.

Grade 1. Less than 25 percent forward slip
Grade 2. 26 to 50 percent
Grade 3. 51 to 75 percent
Grade 4. 76 to 99 percent

If the vertebra has slipped completely off the one below it, meaning that is 100 percent, it is called spondyloptosis.

This is the most severe stage of spondylolisthesis.

Other causes of spondyloptosis include:
Dysplastic or congenital spondyloptosis, which is a congenital deformity due to abnormal formation of the lumbosacral junction or facet joints.

Traumatic spondyloptosis,  which is caused by trauma such as a severe car accident or fall in which both pars interarticularis have fractured and likely also the pedicles, facets, or vertebral body, leading to severe instability and possibly complete slippage.

Pathologic spondyloptosis, in which a spinal conditions like a tumor, infection or metabolic bone disease causes the bone to weaken, allowing forward slipping with or without a pars fracture.

Post-surgical (Iatrogenic) spondyloptosis, in which key stabilizing structures in the spine have been removed during surgery, such as a laminectomy at L5-S1 without proper fusion, may cause the segment to fully slip.

Symptoms of spondyloptosis may be severe.

Typical symptoms include lower back pain, nerve compression (causing pain, numbness, or weakness in the legs), and difficulty walking or standing.

In advanced cases, loss of bladder and/or bowel control can occur.

If left untreated, spondyloptosis can lead to several complications such as permanent nerve damage, loss of bladder and/or bowel control, chronic pain, worsening spinal deformity, and loss of mobility.

Treatment depends on the severity of symptoms and spinal instability.

Most cases of spondyloptosis are treated with surgery.

The main surgical option is spinal fusion to realign and stabilize the spine.

The type of fusion will depend largely on the anatomy and patient’s needs.

It is not uncommon for a combination of posterior fusion and an interbody fusion to be performed in order to stabilize the affected segments of the spine.

If you have symptoms of severe back pain or nerve issues, consult your doctor for evaluation and care.

For more information, visit spine-health.com.