Grade 1 Spondylolisthesis: Causes, Treatments, Recovery Forecasts

Spondylolisthesis is a prevalent spinal condition that may affect adults and teenagers alike. It develops when one of the vertebrae of the spine slips out of its regular position and lands on the vertebra below. The spinal misalignment caused by spondylolisthesis can lead to chronic back pain and nerve symptoms. 

Physicians classify spondylolisthesis using a grading system based on the severity of the condition. Grade 1 spondylolisthesis is the least severe form of the disease, but can still cause significant discomfort. 

This article will explore the topic of grade 1 spondylolisthesis, including the causes, treatments, and recovery forecasts for this condition.  

Table of Content

What Does Grade 1 Spondylolisthesis Mean?

Grade 1 spondylolisthesis means that the affected vertebra has slipped between 1% and 25%. Also known as low-grade spondylolisthesis, grade 1 spondylolisthesis is found in virtually all patients with degenerative spondylolisthesis. Over time, without the appropriate treatment plan, grade 1 degenerative spondylolisthesis is likely to progress into a more severe form of the condition. 

What Causes Grade 1 Spondylolisthesis?

Grade 1 spondylolisthesis is generally caused either by overextending the spine or by age-related spinal wear and tear. The former of these causes is common in young athletes who develop grade 1 spondylolisthesis; the latter occurs in cases of degenerative spondylolisthesis. 

Overextending The Spine

Certain sports involve repeatedly extending the spine and involve a high risk of spinal injury. Young athletes who participate in these sports are more likely to develop grade 1 spondylolisthesis than others. Sports that may lead to overextending the spine include gymnastics, volleyball, diving, and football. 

It’s also worth noting that some individuals are more likely to develop spondylolisthesis than others due to genetic factors. Specifically, some people naturally have thinner bone tissue in the vertebrae, leading to a higher risk of spinal injury.  

Age-Related Spinal Wear and Tear

Throughout a lifetime, the spine is subject to wear and tear with daily activities. High-impact activities, like running and contact sports, as well as having poor posture, can worsen this degeneration. But, aspects of the natural aging process also contribute to age-related spinal wear and tear. 

The spine inevitably changes with age. For one, the intervertebral discs that absorb impact to protect the spine become thinner and drier. Additionally, bone mass reduces with age, leading to thinner spinal structures that are more susceptible to injury. 

All of these factors can contribute to the development of degenerative grade 1 spondylolisthesis, which typically affects patients over the age of 60. 

Is Grade 1 Spondylolisthesis Serious?

Grade 1 spondylolisthesis is considered the least serious form of this spinal condition. Additionally, grade 1 and grade 2 are the most frequently diagnosed forms of spondylolisthesis.

While any spinal condition should be taken seriously to prevent ongoing pain and further injury, grade 1 spondylolisthesis is usually resolved fairly easily. However, if the condition isn’t identified early on, or if the patient doesn’t follow an effective treatment plan, spondylolisthesis can progress. 

What Exercise Can You Do With Slight Grade 1 Spondylolisthesis?

With slight grade 1 spondylolisthesis, you can participate in many different forms of exercise, so long as they don’t excessively strain the spine. In fact, regular exercise is an important component of most spondylolisthesis treatment plans. This is because it promotes spinal mobility and muscle strength. 

Some of the best forms of exercise for grade 1 spondylolisthesis include:

  • Walking
  • Swimming and water aerobics
  • Using an elliptical machine 
  • Certain strengthening exercises, such as side planks and pelvic tilts
  • Gentle stretching
  • Non-intense cycling

Certain forms of exercise can lead to spondylolisthesis progression and worsened symptoms. These include:

  • Weightlifting
  • Some sports, including wrestling, gymnastics, football, and other contact sports
  • Yoga poses that involve back extension
  • Diving
  • Back extensions
  • Sit-ups and crunches
  • Any activity that involves significantly twisting or rotating the spine

Ultimately, you should talk to your doctor about which forms of exercises to participate in with grade 1 spondylolisthesis. As your back heals, your doctor may give you the go-ahead to partake in a wider range of physical activities. 

Can I Run With Grade 1 Spondylolisthesis?

If you have grade 1 spondylolisthesis and are experiencing symptoms, it’s best to avoid running until your doctor clears you to do so. Running is a high-impact activity that can place extra stress on the spine. This may lead to worsened back pain and neurological symptoms. 

What is The Treatment For Grade 1 Spondylolisthesis?

The treatment for grade 1 spondylolisthesis typically includes rest, activity modifications, physical therapy, and anti-inflammatory medications. If required, the patient may also undergo steroid injections or spinal bracing, which helps prevent spinal instability. 

Does Grade 1 Spondylolisthesis Need Surgery?

Grade 1 spondylolisthesis generally doesn’t require surgery. This is because it’s the mildest form of the condition, so its symptoms can typically be alleviated with non-invasive methods. However, spine specialists may recommend surgery for grade 1 spondylolisthesis if:

  • Non-surgical treatment methods fail to provide relief after an extended period
  • Surgery is required to prevent the progression of the condition. 
  • The altered alignment of the spine severely impacts the patient’s function and posture.

Unfortunately, grade 1 spondylolisthesis can’t be cured without surgery. Once the vertebra has slipped out of its normal position, surgery is the only way to restore the alignment of the spine. So, while non-surgical therapies can help with spondylolisthesis, patients may opt for surgery to correct the position of the misaligned vertebra.  

Surgery For Grade 1 Spondylolisthesis

Traditionally, patients who require surgery for spondylolisthesis have undergone spinal fusion. This is rare for cases of grade 1 spondylolisthesis, but not impossible. 

During spinal fusion, the surgeon places an implant containing bone graft material between the affected vertebrae. This bone graft material stimulates bone development in the months following the procedure. Eventually, this leads to the formation of a single, stabilized bone. 

Unfortunately, in fusing the vertebrae affected by spondylolisthesis, spinal fusion eliminates the segment’s range of motion. To avoid this, along with various complications associated with fusion, patients can consider the TOPS System

The TOPS System is a mechanical device that can be implanted into the spine at the affected segment to restore a controlled range of motion. It can be implanted with a minimally-invasive procedure and facilitates extension, flexion, axial rotation, and lateral bending. 

The FDA has approved the TOPS System for people between 35 and 80 years old with degenerative spondylolisthesis (at one level between L3 to L5) and lumbar spinal stenosis. The FDA also labeled the TOPS System as superior to spinal fusion for lumbar spondylolisthesis with spinal stenosis.

Dr. Meyer, a neurosurgeon at the Atlantic Neuroscience Institute, was selected to participate in an FDA study of the TOPS System as a treatment for degenerative grade 1 spondylolisthesis and spinal stenosis. Dr. Meyer notes that the study presents patients with an opportunity to reap the benefits of this innovative device, including a restored range of motion, while correcting their spinal condition. 

What is The Recovery Forecast For Grade 1 Spondylolisthesis?

The recovery forecast for most patients with grade 1 spondylolisthesis is a complete recovery within three to six months. However, this forecast can differ depending on the patient and the chosen treatment route. 

Non-Surgical Treatment Route:

Cases of grade 1 spondylolisthesis that are successfully treated without surgery typically heal within three to six months, as mentioned above. Young patients may heal faster, while older patients may need more time to recover. 

A spine specialist can evaluate your case of spondylolisthesis and provide a personalized recovery forecast based on your age, medical history, exact treatment plan, and degree of slippage. 

Surgical Treatment Route:

Most patients who undergo TOPS surgery for grade 1 spondylolisthesis return to their regular activities within around six weeks. Patients also regain a complete range of motion right after the procedure. With this in mind, patients are subject to far fewer restrictions when compared to traditional spinal surgery after TOPS surgery

After spinal fusion, which is the conventional surgical treatment for spondylolisthesis, patients typically need a full year to recover. Additionally, patients are subject to significant restrictions for around six to eight months following the procedure. 

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Note that all motion in the fused vertebral segment is lost after spinal fusion, which may permanently inhibit some patients’ activities.

If you’ve been diagnosed with grade 1 spondylolisthesis, schedule an appointment with a spine specialist in your area to learn about all of the available treatment routes.