Spondylosis vs. Spondylolysis vs. Spondylolisthesis: Key Differences and Treatment Options

Spondylosis, spondylolysis, and spondylolisthesis are spinal conditions that are spelled – and sound – very similar. As a result, these terms are commonly confused. However, they’re all distinct conditions with different definitions, symptoms, and treatment options. 

This article will dispel any confusion surrounding spondylosis, spondylolysis, and spondylolisthesis by exploring the differences between these conditions. 

What Are the Main Differences Between Spondylosis, Spondylolysis, and Spondylolisthesis?

The main difference between spondylosis, spondylolysis, and spondylolisthesis is how each condition affects the vertebra. Spondylosis is osteoarthritis of the spine; spondylolysis is a vertebral stress fracture; and spondylolisthesis involves vertebral slippage. 

“Spondyl” is a prefix derived from the Greek word “spondylos”, meaning spine. This explains why spondylosis, spondylolysis, and spondylolisthesis are very similar in wording, as all three conditions affect the spinal vertebrae. However, other than the body part that these conditions affect, they’re quite different in definition. 

Spondylosis Definition and Treatment

Spondylosis is defined as degenerative spinal arthritis, or osteoarthritis of the spine. It affects virtually everyone in their later years, although excessive impact on the spine can cause it earlier in life. Spondylosis results from normal degeneration, or wear and tear, of the spine, affecting the joints, discs, and other spinal structures. 

Bone spurs are a common complication of spondylosis, as it increases friction within the spinal joints. Bone spurs can contribute to other spinal conditions, including spinal stenosis and nerve compression. 

The symptoms of spondylosis typically include:

  • Lower back pain
  • Worsening pain with particular movements or activities, like bending over and coughing
  • Reduced range of motion in the back
  • A grinding sensation when you move the back
  • Neurological symptoms, like weakness, tingling, and numbness that radiate from the back to the extremities
  • Bladder control problems
  • Muscle spasms

Spondylosis treatment generally includes:

  • Physical therapy 
  • Pain medications, either over-the-counter or prescription
  • Activity and lifestyle changes
  • Home remedies, like heat/cold therapy
  • Epidural steroid injections
  • Spinal decompression surgery, in severe cases

Spondylosis Risk Factors

Risk factors for spondylosis include:

  • Being over 60 years of age
  • Having a profession that involves repetitive movements, like lifting
  • A sedentary lifestyle
  • A family history of spondylosis
  • Smoking 
  • Repetitive trauma to the spine
  • Previous spinal injuries
  • Poor posture

Spondylolysis Definition and Treatment

The definition of spondylolysis is a stress fracture in one of the spinal column bones, called vertebrae. This fracture, or crack, usually results from repeated stress on the vertebrae, although some children are born with this condition. It’s also a common sports injury in children and teens, although it can develop in people of all ages. 

More specifically, spondylolysis involves a crack in the pars interarticularis. This is a small, particularly weak portion of the vertebra that connects it to the adjacent vertebra. So, by weakening the pars interarticularis, spondylolysis can compromise the vertebra’s stability, increasing the risk of spondylolisthesis. 

Common symptoms of spondylolysis include:

  • Dull, aching, lower back pain that worsens with physical activity
  • Pain that radiates into the lower extremities
  • Tight hamstring muscles
  • Muscle spasms
  • Numbness, tingling, and weakness in the lower extremities

Spondylolysis treatment options can include:

  • Resting from sports and other forms of physical activity
  • Physical therapy 
  • Back bracing 
  • Pain medications
  • Bone growth stimulation, which involves using a specialized device that administers electrical or ultrasound technology to promote bone growth
  • Surgery, in rare cases, to resolve chronic back pain or spondylolisthesis resulting from the fracture

Spondylolysis Risk Factors

Spondylolysis risk factors include:

  • Sports participation, particularly in sports that involve repetitive spinal strain, like weightlifting, gymnastics, and contact sports
  • A profession that involves repetitive back movements
  • Repetitive spinal trauma
  • Growth spurts in teens
  • A family history of spondylolysis
  • Genetic factors and being born with a naturally thin pars interarticularis

Spondylolisthesis Definition and Treatment

Spondylolisthesis is a spinal condition characterized by a vertebra slipping out of place. The vertebra settles on the bone beneath it, causing pressure and instability. Spondylolisthesis is particularly common in the lumbar spine and can result from genetic defects, injuries (including spondylolysis), or age-related degeneration. 

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Not all spondylolisthesis cases trigger noticeable symptoms, particularly if the affected vertebra doesn’t impinge on nearby nerves. However, if it does cause symptoms, they may include:

  • Lower back pain that worsens while walking or standing and may radiate into the lower extremities
  • Tight hamstring muscles
  • Numbness, tingling, and weakness that radiates into the legs
  • Abnormal gait or difficulty walking

Spondylolisthesis may be treated with a range of methods, including:

  • Activity modifications, mainly avoiding activities that worsen pain, like lifting and bending
  • Physical therapy
  • Back bracing
  • Pain medications
  • Alternative remedies, like massage therapy and acupuncture
  • Surgery, in severe cases, to resolve nerve impingement and re-stabilize the spine

Spondylolisthesis Risk Factors

Risk factors that can elevate your risk of developing spondylolisthesis include:

  • Advanced age
  • A family history of spondylolisthesis
  • Genetic factors or being born with thin vertebrae
  • Repetitive trauma to the lumbar spine
  • Sports participation, particularly in weightlifting, gymnastics, and contact sports
  • Growth spurts in teens
  • Other spinal conditions, like a spinal tumor
  • Conditions that impact bone health, like osteoporosis
  • Obesity 

Spinal Condition Symptoms That Require Diagnostics

The human spine (vertebral column) with the name and description of all sites. Dorsal, lateral, ventral sides. Human anatomy. Vector illustration isolated on white background.

Spinal condition symptoms that require diagnostics include persistent back pain, neurological symptoms, balance or coordination issues, and changes in bladder or bowel function. 

Persistent or Chronic Back Pain

If you’re struggling with significant back pain that doesn’t resolve after a week of home remedies, like rest and heat/ice therapy, it’s time to see a doctor for a diagnosis. While persistent back pain doesn’t necessarily point to a serious spinal condition, it’s best to get it checked out early. If your pain is related to a spinal condition, early intervention will facilitate a quicker, easier recovery process. 

Neurological Symptoms

Neurological (also known as nerve-related) symptoms are typically a sign of nerve compression – a common complication of various spinal conditions, including spondylosis, spondylolysis, and spondylolisthesis. Neurological symptoms that occur with spinal conditions include:

  • Pain that radiates from the back to the lower extremities
  • Numbness in the extremities
  • A tingling or “pins and needles” sensation, which typically occurs in the extremities
  • Weakness in the legs or feet

Neurological symptoms occurring in the lower extremities (the legs and feet) indicate an issue in the lumbar spine. Since the lumbar spine is the most flexible spinal region and must support the entire weight of the torso, it’s most commonly impacted by various spinal conditions. 

Balance and Coordination Issues 

When spinal conditions lead to nerve impingement, it can impact your balance and coordination. This occurs as the signals between the brain and the muscles supplied by the impinged nerve are disrupted. You may feel unsteady, struggle to walk in a straight line, or experience dizziness. 

With these symptoms, it’s crucial to seek a professional diagnosis. Left alone, the nerve impingement can worsen and eventually impact your mobility. 

Changes in Bladder or Bowel Function

Bladder or bowel dysfunction points to an advanced, severe spinal condition. If you suddenly experience this symptom, seek emergency medical care. You may have a serious complication of spinal nerve compression known as cauda equina syndrome. 

When in doubt, see a doctor to evaluate potential symptoms of a spinal condition. Starting treatment as early as possible will help prevent the need for invasive methods to resolve your symptoms.