Cervical spondylolisthesis is the medical term for one neck vertebra slipping forwards or backwards over the one beneath it. It is far less common than the same problem in the lower back.
A small, stable slip may cause no trouble and need no treatment. A larger or unstable slip can narrow the spinal canal or the nerve exits, compressing the spinal cord or nerve roots. Treatment depends on symptoms and stability, not on the X-ray appearance alone.
Symptoms
- Neck pain and stiffness
- Pain, tingling or numbness running into a shoulder, arm or hand
- Weakness of grip or arm muscles
- Clumsy hands, such as difficulty with buttons or writing
- Unsteady walking or heavy legs
- Headache at the back of the head
- Bladder urgency in advanced cord compression
Causes and risk factors
In adults the usual cause is wear of the discs and facet joints with age, which loosens one level, often C3-4 or C4-5 above a stiffer segment. Other causes are trauma with fracture or ligament injury, rheumatoid arthritis, which particularly affects the top two vertebrae, previous neck surgery, congenital bone anomalies and conditions with lax ligaments such as Down syndrome.
How it is diagnosed
- Standing X-rays with flexion and extension views: Show the amount of slip and whether it moves, which indicates instability.
- MRI of the cervical spine: Shows compression of the spinal cord and nerve roots and any signal change inside the cord.
- CT scan: Details bone anatomy, fractures and facet joints, and helps plan screws.
- Neurological examination: Reflexes, strength, hand function and gait identify myelopathy.
- Nerve conduction studies and EMG: Separate a trapped nerve root from problems such as carpal tunnel syndrome.
Treatment options
- Observation: A stable slip without nerve symptoms is simply reviewed if things change.
- Physiotherapy and pain relief: Posture work, deep neck muscle strengthening, anti-inflammatory medicines and activity adjustment.
- Injections: Nerve root or facet injections for arm or joint pain in selected people. Relief is often temporary.
- Anterior cervical discectomy and fusion: The disc is removed from the front, the alignment corrected and the level fixed with a cage and plate.
- Posterior decompression and fusion: Screws and rods from the back, with removal of bone over the cord when several levels are narrowed.
- Combined front and back surgery: For marked instability, deformity or traumatic slips.
When it is urgent
After any significant accident, neck pain with numbness or weakness needs emergency care and the neck kept still. Rapidly worsening arm or leg weakness, loss of bladder or bowel control, or sudden difficulty walking also require immediate local assessment.
Travelling to Türkiye for treatment
Bring your MRI and the flexion and extension X-rays: a surgical opinion can often be given remotely first. Planned fusion surgery fits a stay of about 10 to 14 days, with a collar sometimes used for several weeks. Fusion takes 3 to 6 months to consolidate, so arrange follow-up X-rays and physiotherapy at home. Progressive cord symptoms should be treated promptly wherever you are, not delayed for travel.
Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.
Frequently Asked Questions
Can the slipped bone be pushed back?
Manipulation cannot correct it and may be unsafe when there is instability. Surgery can realign and fix the segment when needed.
Do I need an operation?
Only if there is spinal cord compression with symptoms, persistent nerve pain or weakness despite treatment, or clear instability.
Will fusion stop me moving my neck?
One or two fused levels reduce movement only slightly. Longer fusions restrict turning and bending more noticeably.
Is this the same as a neck hernia?
No. A herniated disc is bulging disc material. They can occur together, and both can press on nerves.