Degenerative Spondylolisthesis

Osteoarthritis of the facet joints can also lead to instability of a vertebral segment. Typically, as continued degeneration weakens the facet joints, the L4 vertebral body slips forward on the L5 vertebral body (see Figure 1). Since the L4-L5 segment has substantial flexion-extension type movement, this area is most likely to slip. The next most likely level is L3-L4, and rarely L5-S1.

As the body tries to capture the unstable segment, the facet joints get bigger and place pressure on the nerve root (lumbar spinal stenosis). Therefore, both the symptoms and conservative treatment are essentially identical as for patients with lumbar spinal stenosis.

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