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What Is Anterolisthesis?

Mary McMahon
Updated Mar 03, 2024
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Anterolisthesis is a spinal disorder characterized by a dislocation of at least one vertebra relative to another. It occurs when an upper vertebral body, the main part of a vertebra, slips forward relative to the vertebra below. As it moves out of position, it can pinch the spinal nerves connected to the vertebrae involved in the displacement, and also potentially damage the spinal cord. This condition is graded by severity on the basis of how far forward a vertebra has slipped.

Fractures are the most common reason for anterolisthesis, although there can be other causes as well. This condition is most commonly observed with the fourth and fifth lumbar vertebrae, although it can arise in other regions of the spine. Patients can experience a variety of symptoms, depending on the location and severity of the anterolisthesis. Some common signs are numbness, tingling, abnormal sensations, loss of bowel or bladder control, pain in the spine or in the region innervated by the involved nerves, and difficulty controlling the legs.

Medical imaging studies are used to visualize the spine. The displaced vertebrae will be clearly visible in the images and a physician can measure to determine the degree of displacement. This will be taken into account, along with the results of a patient interview, when developing a treatment plan. If the patient has a history of spinal injuries or other problems, a doctor may feel that conservative treatment will not be enough to address the problem.

Conservative treatments for anterolisthesis consist of rest and gentle physical therapy. The patient may be put on bed rest to allow the spine to recover without strain and the healing process can be extended. If the injury is severe, a doctor may recommend skipping this treatment and proceeding to surgical options such as spinal fusion, where the displaced vertebra will be moved back into place and fused to a neighbor to hold it in alignment. Spinal surgery will fix the abnormal positioning of the vertebrae although it can come with serious risks including the risk of infection or permanent nerve damage.

When diagnosed with anterolisthesis, patients may find it helpful to ask about the available treatments and to get information about the risks and benefits of each. The doctor can also discuss possible recovery time and other issues that may be important for the patient to know about. Patients should be aware that while surgery can reposition the vertebrae, symptoms like pain and neurological problems can sometimes persist.

What Causes Anterolisthesis?

There are six main contributing factors for anterolisthesis: aging, traumatic injuries, repetitive stress fractures, congenital spinal problems, degenerative diseases and surgical side effects. Some people are more at risk for the condition than others.

Blunt Force Impacts and Injuries

One of the most common causes of anterolisthesis is a traumatic injury. Sudden, strong impacts can move vertebrae out of alignment and into an abnormal position. Several situations can lead to this type of injury:

  • Car accidents
  • Impacts from football, lacrosse basketball and other team sports
  • Slips and falls
  • Workplace accidents
  • Impacts from falling objects

Severe trauma can go so far as to fracture a vertebra, causing it to slip out of place. Fractured vertebrae are weaker, so they’re more likely to have problems with anterolisthesis in the future.

Repetitive Trauma Injuries

Athletes can experience problems with anterolisthesis due to small but repetitive injuries to vertebrae. Young people are especially vulnerable to this type of damage because the spinal column and bones of the body are still in development. Here are some sports that can weaken vertebrae gradually:

  • Soccer
  • Football
  • Sprinting
  • Wrestling
  • Weightlifting
  • Gymnastics
  • Diving

These sports activities require athletes to stretch past comfortable limits, overextending their arms, legs or entire body. If the extreme movements continue, they can cause damage to the vertebrae and spinal alignment.

Age-Related Changes to the Spine

As people age, the cartilage of the spine loses water, gets thinner and becomes more vulnerable to damage. In this situation, cartilage doesn’t cushion vertebrae properly. Instead of a snug fit that holds bones firmly in place, vertebrae become “loose” and can slip out of place more easily. When this happens, seemingly minor injuries to the lower back that wouldn’t have caused problems before can now cause anterolisthesis.

Certain Diseases

While less common, sometimes anterolisthesis is caused by a degenerative disease:

Any disease that weakens the structure of bones or cartilage increases the chance of vertebrae moving out of place. Tumors can contribute to anterolisthesis if they increase in size. As they grow, they push vertebrae into incorrect positions.

Congenital Problems and Inherited Risk Factors

Some children are born with a misaligned spinal column. This condition puts them at risk for anterolisthesis later on. Scientists aren’t completely sure why some babies have this problem.

There are also inherited risk factors that can make certain people more likely to experience spinal issues as adults. They may have weaker vertebrae that are simply more prone to stress fractures or slippage.


Surgery can sometimes leave individual vertebra more vulnerable to slippage. At times, this is due to a medical error, and other times it’s merely a side effect of the type of surgery needed. If doctors have to remove a piece of bone or change its shape, the vertebrae may not fit together as closely as before.

What Is the Difference Between Anterolisthesis and Spondylolisthesis?

When one of your spinal vertebrae slips out of place, this is known as spondylolisthesis. Depending on the direction the vertebra moves, doctors sometimes refer to the condition by different names. When a vertebra slides forward, it’s called anterolisthesis. If a vertebra moves backward, the condition is referred to as retrolisthesis.

The symptoms are virtually identical in all cases. You can say that anterolisthesis and retrolisthesis are both types of spondylolisthesis.

Is Anterolisthesis Serious?

Anterolisthesis affects everyone differently. The degree it affects your life depends on the symptoms you’re experiencing, how intense they are and the original cause of spinal problems. Some people experience severe pain that makes it hard for them to work or care for children. Other people hardly notice any symptoms at all.

The good news is that the outlook for people who have anterolisthesis is very positive. Depending on the extent of slippage, recovery may only require physical therapy and exercises to strengthen your lower back muscles.

Surgery is generally used as a last resort. Many patients respond well to surgery, resuming their day-to-day activities in a few months. Surgery can prevent vertebrae from slipping in the future.

When Should Visit a Doctor for Anterolisthesis?

If you think you may have anterolisthesis, you should schedule an appointment with your doctor right away. This condition won't disappear on its own. The sooner you receive treatment, the sooner you can experience relief. Prompt treatment may prevent the condition from getting worse.

In rare situations, the nerve roots of the lower back can become compressed. This is a dangerous complication that can lead to paralysis. If you ever have trouble feeling your legs after an accident, call 911 immediately.

TheHealthBoard is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
Mary McMahon
By Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a TheHealthBoard researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Discussion Comments

By anon992628 — On Sep 20, 2015

I just received my X-ray results. I can't access my MRI results, but the X-ray showed Anteriolisthesis cervical spine in two vertebrae. I've been in horrible pain for years but it's getting worse and my meds need adjusting because they do t control the pain any longer. It's so bad and you never know when it's going to hit you.

I have a great GP, but the pain manager at a high end prestigious university medical center makes me feel knee high to a piss ant. He hasn't seen my X-ray or MRI yet and had me scheduled with a NP. He wants me off all pain meds but the pain will kill me.

By anon948116 — On Apr 28, 2014

I just received my MRI results. I have not seen the doctor yet. I'm in so much pain and have no idea what this report says. Any help with it would be appreciated. I was told to wait to make any appointments until my regular doctor could read the results, but she can sometimes take up to two weeks to get to things. It took two months to get the MRI because of doctor/insurance miscommunications. Thank you in advance!

C2-C3 - 1 mm of anterolisthesis, advanced degenerative change at the left facet,

C3-C4 - greater than 3 mm of anterolisthesis, severe hypertrophic degenerative change at left facet, diffuse narrowing of the foramen, overall mild, appears patently inferiorly, more narrowed superiorly.

C4-C5 - broad-based disc/osteophyte slightly greater to the right of midline. Narrowing of the right lateral recess an foramen mild. Osteophyte involving uncovertebral joint. Mild reversal of lordosis.

C5-C6 - broad-based disc/osteophyte. Far paracentral and lateral osteophytes in the region of unconvertebral joints. Mild narrowing of the right foramen.

L4-L5 - level is desiccated and narrow. Disc bulge is seen. Facet ligament overgrowth results in a trefoil appearance the thecal sac and mild narrowing of the canal. The AP thecal sac is estimated at 7-8 mm. Some narrowing of the lateral recess noted bilaterally. Moderate narrowing of the foramen bilaterally.

L5-S1 - level is desiccated. A right posterior lateral disc bulge and posterior lateral disc protrusion is seen which effaces the right lateral recess. Abuts and may be compromising the descending right S1 nerve root. Facet overgrowth is seen the changes result in mild left, mild to moderate right bony foraminal stenosis on the right. No canal stenosis is seen.

By anon927572 — On Jan 24, 2014

Only an MRI can determine this. I had a CT scan with contrast which came back normal (at the ER). My doctor ordered an MRI which showed a 1mm C3 anterolisthesis relative to C4 consistent with ligamental laxity. A CT scan doesn't show soft tissue which is why an MRI is highly necessary. My condition was caused by a car accident on the highway. I had to come to a complete stopped position due to traffic ahead of me. The car behind me (not paying attention) swerved into the right lane to avoid hitting me, however the car behind him slammed into the back of me full speed.

I saw everything as I was looking in my rearview mirror but couldn't avoid the collision due to ongoing traffic in both the left lane and the right lanes. My natural instinct caused me to stiffen my body and drop my head as I was holding the steering wheel. The whip lash caused the ligaments in my neck (between the C3 and C4) to loosen (ligamental laxity), thus causing anterolisthesis.

By anon339627 — On Jun 25, 2013

I was diagnosed with severe anterolisthesis in C4 and S1, and degenerative disc disease with neural foraminal stenosis with pars defect in November.

My consultant hadn't received my MRI results and sent me for an X-ray, and he was shocked that I had been coping on the usual painkillers and tramadol and ordered a CAT scan. I saw him when the results came back, and he told me he couldn't put my vertebrae back and my only option was to fuse my spine in the position it was in.

I had my surgery date for April, so I had three months to wait. Over that time I deteriorated. I had a pre-op assessment and had an infection so my surgery was postponed until it was clear. I received my second surgery date for late May. During this waiting time, I got even worse. My hands, knees and feet swelled to twice their size and I had severe upper body pain in my neck, shoulders hands.

My meds were increased, 50mg fentanyl, 180mg morphine sulphate, 60mg amitriptyline, 15 mg diazepam, but I was still in immense pain. Then I had an emergency MRI on my neck in early June, only to be told I can't see my consultant until early August.

I am now suicidal, and everything I do is excruciating. I'm driving my family insane. I lost my £25,000 a year job since I've been unable to work since may last year. What will happen to me if I don't have a spinal fusion? I can't believe this is happening to me. Even typing this post on a touch screen hurts and I fall over quite a bit. I don't know how much longer I can go on for and will this operation be successful?

By anon332532 — On Apr 29, 2013

My doc saw I had this on an X-ray! I haven't had a MRI yet to see if there is anything else wrong with my back.

By anon298850 — On Oct 22, 2012

I had a motorcycle wreck in 2003. I fractured all five lumbar vertebrae, and L2 was a burst fracture. 1/2 of L2 has been removed. I also had a right heel bone fracture (split in two), five ribs shattered on right side, one rib shattered on left, and a right collapsed lung.

My only option was spinal fusion from T12 to L3. Had it not been for this fusion, I would have probably never been able to walk again. The fusion has helped stabilize my spine, and is not as uncomfortable as you would imagine. I do feel temperature changes due to the rods in my back.

So for those of you who fear it, it's not that bad. My accident was pretty severe and it was a miracle I was not paralyzed. I do live with constant pain and my only option at this time is Oxycodone. That drug does wonders to mask the pain. I take 5mg tablets (with no other mixed ingredient), manufactured by Qualitest; 6-7 mgs four to six times a day.

Rather than deal with unbearable pain, and then a large does of painkiller, I take this low dose all day. That helps me to be able to function; I am computer programmer and definitely need a clear head to do my work.

By anon296255 — On Oct 10, 2012

I hear things like fusing vertebra together and that scares me. I have a fusion of C6 to C7. My head does not turn like it used to turn. ow the doctor wants to fuse C4 to C5 and C5 to C6. One long straight bone with four vertebrae together. No thanks.

I started researching and they are doing disc replacements now, in addition to a couple of other treatments. There is no way I would do a fusion!

By anon275583 — On Jun 18, 2012

I was diagnosed a year and half ago with degenerative disk disorder disease. They fused disks 3-7. I was paralyzed after my surgery and was unable to move my arms. They figured out that I had contracted Brachial Neuritis. I finally got the movement back in my arms but I have no strength.

I have been coming down with a lot of headaches lately. They did an x-ray of my neck and I got the results back. Basically is says that i have anterolistesis at c2-c3. Not knowing what this means, I looked it up. All I can say is wow. My c2 is slipped over my c3 and the only fix is spinal fusion. What? I just had surgery, so why didn't they fix it then?

I am scared to go back under the knife. Really, how much more can this poor body of mine take? Wish me luck!

By anon269508 — On May 18, 2012

I was just diagnosed having this by having an MRI. I'm having surgery this coming Monday. I have been having the pain in my legs and buttocks for over a year. It has only gotten worse. I also can't stand or sit for long periods of time. The pain feels like someone is jerking my muscles away from my bones. My pain is unbearable.

By Flora — On Jan 09, 2012

She will need to get her doctor to order an MRI or CT scan. You can not see it on just a plain x-ray.

I know when it hit me, I could hardly walk and was falling down at times. With this type of condition, you feel like your back is being snapped in half. The pain really never goes away but with pain meds it eases it a bit.

So the only way to really diagnose her back condition is to get the MRI or CT scan done.

Good luck to your mother. If this is what she has, it is not fun at all. My hips and legs go numb after a while and I can't sit or stand very long either.

By anon239133 — On Jan 07, 2012

An MRI is not necessary. A CT without contrast is enough to diagnose. The MRI looks at spinal cord signals. The CT looks at bone placement in relation to the spine.

By Flora — On May 03, 2011

An MRI is going to be necessary to diagnose this. I just had an MRI done yesterday and I have this and am in severe pain all the time.

By bbright — On Apr 11, 2011

My mother has recently been having some trouble with her back, and after reading this I'm worried that she might have anterolisthesis -- she has all the symptoms listed above, and she has always had trouble with her back.

Do you think that this could be what's wrong with her? Are there any ways to tell without getting an MRI or imaging study done? Any help would be very much appreciated.

Mary McMahon

Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a...

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