Column What is the Relationship Between Spondylolisthesis and Osteoporosis? Reasons for The Higher Prevalence in Women and Points to Be Careful About
August 8, 2025
Spondylolisthesis is considered one of the most prevalent spinal disorders, alongside lumbar disc herniation and lumbar spinal stenosis.
This article will explain the relationship between spondylolisthesis and osteoporosis.
What is spondylolisthesis?
Lumbar spondylolisthesis refers to a condition where vertebrae in the lower back shift out of their normal position.
Spondylolisthesis can be divided between “anterolisthesis” in which the bone slips forward, and “retrolisthesis” where it slips backward.
Recent research indicates that intervertebral disc degeneration is a contributing factor to spondylolisthesis (*1).
The stress of daily life and aging cause degeneration of structures like the intervertebral discs. As disc degeneration progresses, it also leads to degeneration of the facet joints and vertebral bodies. As a result, the lumbar vertebrae shift out of their normal position.
*1: I. Akkawi, H. Zmerly. Degenerative Spondylolisthesis: A Narrative Review. Acta Biomedica, vol. 92, No.6, 2021.
Symptoms of spondylolisthesis
The primary symptoms of lumbar spondylolisthesis are lower back pain, buttock pain, and pain and numbness in the lower limbs. However, mild cases may be asymptomatic.
One common symptom of spondylolisthesis is numbness or pain in the buttocks and lower limbs that occurs while walking. This is called intermittent claudication. Its characteristic feature is that walking becomes impossible due to pain, only to resume after a short rest.
What is osteoporosis?
Osteoporosis refers to a condition where bone mass (bone density) decreases, causing them to become porous like a sponge. This makes bones brittle and prone to fractures.
Hormonal changes are a primary cause of osteoporosis. Particularly in postmenopausal women, the secretion of estrogen, a female hormone that promotes bone formation, decreases, making bones more prone to becoming brittle. Consequently, the incidence of osteoporosis is higher in older women.
Symptoms of osteoporosis
In most cases, there are no symptoms in the early stages. Symptoms often only appear once osteoporosis has progressed.
When bones become brittle, even minor incidents (lifting something heavy, sitting down forcefully, sneezing, etc.) can lead to fractures.
If the spine fractures, the person may not be aware it has broken, and in some cases, vertebrae can collapse one after another.
A loss of 3 cm or more in height may indicate a fracture. Symptoms such as back or waist pain when standing up, or a noticeable curvature of the spine, can suggest a fracture caused by osteoporosis.
The relationship between spondylolisthesis and osteoporosis
Spondylolisthesis and osteoporosis are interrelated.
The back pain and restricted movement caused by spondylolisthesis can lead to reduced physical activity, which can in turn aggravate osteoporosis.
Conversely, when bones become brittle due to osteoporosis, vertebrae are more prone to slipping, increasing susceptibility to spondylolisthesis. Additionally, vertebral fractures caused by osteoporosis can potentially trigger spondylolisthesis.
It is not uncommon for individuals to have both spondylolisthesis and osteoporosis concurrently. When both conditions coexist, symptoms like lower back pain, leg numbness, and difficulty walking can worsen, significantly impacting daily life.
A multi-modal treatment is essential
Once diagnosed with spondylolisthesis, a multi-modal treatment approach is crucial to prevent progression of the condition.
Our clinic employs various treatment approaches to alleviate back pain, aiming to improve patients’ quality of life (QOL) and extend their lifespan in good health.
The Cellgel Method
As mentioned earlier, the cause of spondylolisthesis is believed to be intervertebral disc degeneration. Therefore, repairing the degenerated discs can prevent spondylolisthesis and halt its progression.
Our Cellgel Method involves injecting a medication that fills the cracked portion of the disc. This medication solidifies into a gel-like substance, repairing the cracks and providing a fundamental treatment. A key feature is that the disc volume is not reduced, and after treatment, the agent remains in the disc as a gel-like implant, preserving the disc.
Unlike conventional surgery, the Cellgel Method does not involve any incision, resulting in fewer postoperative risks.
The treatment takes only half a day at the clinic, and patients can walk home on the same day.
The Florence Method / The Q-Florence Method
The Florence Method and Q-Florence Method are performed to treat spinal canal stenosis.
The Florence and Q-Florence methods are minimally invasive, low-risk treatments for spinal canal stenosis.
Under partial anesthesia and sedation, a device is percutaneously inserted to widen the stenosed spinal canal.
The device is inserted to stabilize the vertebral body while preserving vertebral rotation and flexion, widening the spinal canal and reducing disc protrusion and ligamentum flavum thickening. Pain is eliminated by widening the narrowed spinal canal.
The Florence and Q-Florence methods are minimally invasive and low-risk procedures, and there have been no reports of post-treatment complications or recurrence of symptoms to date.
The Q-Florence Method (article in Japanese)
Post-Treatment Support
Working in conjunction with our various treatment methods, we aim to comprehensively eliminate pain by reviewing daily movements, improving lifestyle habits, and enhancing the overall effectiveness of our treatments.
If you have been diagnosed with spondylolisthesis, consider a consultation at our clinic.
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