Anterolisthesis is an abnormal alignment of bones in the spine and usually affects the lower back. It occurs when an upper vertebra slips forward on the one below, leading to pain and other symptoms.

Anterolisthesis is a type of spondylolisthesis, which refers to any abnormal forward or backward movement of one vertebra in relation to another.

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 according to how far forward the vertebral body is on the one below it. Treatment can range from bed rest to surgery.

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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:

In severe cases, the following symptoms may occur:

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

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 ligaments and joints that hold the vertebrae in proper position begin to weaken. This can create instability in some people and result in degenerative spondylolisthesis.

Anterolisthesis can also be linked to 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.

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: up to 25 percent slippage
  • Grade 2: up to 50 percent slippage
  • Grade 3: up to 75 percent slippage
  • Grade 4: 76-100 percent 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.

Rest can also help prevent further slippage or damage to the vertebrae.


Non-steroidal anti-inflammatory drugs (NSAIDs) can be used to help treat the pain and inflammation caused by anterolisthesis.

For more acute pain, steroids and opioids may be required. Epidural steroids injected directly into the back may reduce inflammation and ease the pain.


Complicated symptoms may be treated with physical therapy, often alongside an exercise program.

A brace or back support might be used to help stabilize the lower back and reduce pain.


Exercises are usually carried out in conjunction with physical therapy. Exercise can increase pain-free movement, improve flexibility, and build strength in the back muscles.

Stabilization exercises can maintain mobility of the spine, strengthen the abdominal and back muscles, and minimize painful movement of the bones in the affected spine.


Surgery is a last resort in the treatment of anterolisthesis. It may be necessary if the vertebra continues to slip or if the pain persists despite other treatments.

Surgery may involve adjusting the vertebrae with plates, wires, rods, or screws.

Usually, one of the following surgical procedures is used to treat anterolisthesis.

  • Decompression: This is when bone or other tissue is removed to release pressure on the vertebrae and associated nerves.
  • Spinal fusion: This is when a piece of bone is transplanted into the back of the spine. The bone heals and fuses with the spine. This creates a solid bone mass that helps stabilize the spine.

A combination of decompression and spinal fusion may also be considered.

Older people are more likely to be affected by anterolisthesis. It usually occurs in people over 50 years old, with women reporting a faster rate of development.

The natural aging process causes the bones to weaken and become more susceptible to damage, including anterolisthesis.

People who engage in regular strenuous activity increase their risk of acquiring anterolisthesis. These include athletes and weightlifters in particular.

The risk of anterolisthesis can be reduced by:

  • strengthening the back and abdominal muscles
  • participating in sports that minimize the risk of lower back injury, such as swimming and cycling
  • maintaining a healthy weight to reduce stress on the lower back
  • eating a well-balanced diet to help maintain bone strength

Below are some commonly asked questions about anterolisthesis.

What is the best treatment for Anterolisthesis?

The best treatment for anterolisthesis depends on the severity of the case. A doctor may recommend bed rest and pain medication for people with mild symptoms, while more severe cases will require chiropractic therapy and surgery.

Is Anterolisthesis degenerative?

There are several causes of anterolisthesis, including blunt force and fractures, strenuous physical exercise, or aging.

Anterolisthesis that occurs over time, due to general wear and tear on the spine, is known as degenerative anterolisthesis.

Depending on the grade of slippage a person experiences with anterolisthesis, treatment ranges from bed rest and pain medication to chiropractic therapy and surgery.

According to some sources, there is a high success rate in non-surgical treatment for mild cases of anterolisthesis. If the bones are not pinching any nerves, there might never be a recurrence of back pain after treatment.

In cases where the nerves are being pinched after bone slippage, there is a risk of permanent nerve damage. This may cause continued or recurrent back pain even after treatment.

Some researchers state that decompression surgery is successful in relieving symptoms in 73% of cases of anterolisthesis.