Disc spondylolisthesis symptoms vary from patient to patient, and may include:

• Pain, especially after exercise, in the low back, thighs and/or legs
• Sciatica pain that radiates into the buttocks or down the legs
• Muscle spasms
• Leg weakness
• Tight hamstring muscles
• Irregular gait or limp

Some people with this condition are symptom-free and only discover the disc disorder when they see a doctor for other health concerns. In severe cases of degenerative spondylolisthesis, however, the vertebral body's forward slip may lead to symptoms of spinal stenosis, nerve compression and neurological injury.

Princeton Brain, Spine & Sports Medicine neurosurgeons use the latest diagnostic technologies and decades of collective expertise to diagnose your spine condition. Diagnostic tools may include:

• Medical history. Your physician will inquire about your symptoms, their severity and the treatments you have already tried.
• Physical examination. Our neurosurgeons will carefully examine you for movement limitations, balance problems, loss of reflexes in the extremities, pain levels, muscle weakness, loss of sensation and other signs of neurological damage.
• Diagnostic tests. Generally, doctors start with x-rays, which allow them to rule out other problems like tumors or infections. They may also use a CT scan or MRI to confirm your spinal diagnosis. A myelogram may be used to show nerve compression, slippage between involved vertebrae and abnormal movement. This test involves an injection of liquid dye into the spinal column.

Several methods are used to “grade” the degree of vertebral slippage, ranging from mild to most severe. Your neurosurgeon will explain the extent of your spondylolisthesis, answer your questions thoroughly and help you make an informed treatment plan with a best-case outcome. The Meyerding classification system is used to grade spondylolisthesis. Slips are graded by the percentage that one vertebral body has slipped forward over the vertebral body below.

• Grade 1 Slip: 1 to 24%
• Grade II: 25 to 49% slip
• Grade III: 50 to 74% slip
• Grade IV: 75 to 99% slip
• Grade V (spondyloptosis): one vertebral body slips entirely off the vertebral body below.

Your PBSSM physician will consider the degree of slip and factors like intractable pain and neurological symptoms when recommending the most suitable treatment. Most degenerative spondylolisthesis cases are grade I or II. As a general guideline, the more severe slips (grades III and above) are most likely to require surgical intervention.