Which Grade of Spondylolisthesis Do I Have? 1, 2, 3, 4, or 5

Dec 13, 2020

Welcome to Regency Square Care Center, your trusted source of information in the Health - Geriatric and Aging Care category. In this comprehensive article, we will address the topic of spondylolisthesis grading and help you understand which grade you may have.

Understanding Spondylolisthesis

Spondylolisthesis is a condition characterized by the forward displacement of one vertebra in relation to another, often resulting in pain and reduced mobility. It occurs most commonly in the lumbar spine and can be classified into different grades based on the severity of the displacement.

Spondylolisthesis Grades

Spondylolisthesis grading is an essential aspect of understanding the condition and determining the appropriate treatment approach. The grading system is based on the percentage of displacement of the affected vertebra. Let's explore each grade in detail:

Grade 1: Mild

In grade 1 spondylolisthesis, the vertebra has a 0-25% displacement. This is considered a mild form of the condition, often causing minimal symptoms. Many individuals with grade 1 spondylolisthesis may not even be aware of their condition unless it is incidentally discovered during imaging tests for another reason. Conservative treatment options, such as physical therapy and pain management, are typically recommended.

Grade 2: Low to Moderate

Grade 2 spondylolisthesis involves a 25-50% displacement of the vertebra. This grade falls within the low to moderate range and may cause more noticeable symptoms compared to grade 1. Pain and decreased range of motion are common complaints. Non-surgical interventions, including exercise programs or temporary bracing, are usually recommended as initial treatment options.

Grade 3: Moderate to Severe

When the vertebral displacement falls between 50-75%, it is classified as grade 3 spondylolisthesis. This grade is considered moderate to severe and often results in significant pain, nerve compression, and limited mobility. A combination of conservative treatments, such as physical therapy and pain management, may be attempted before considering surgical interventions.

Grade 4: Severe

Grade 4 spondylolisthesis denotes a 75-100% displacement of the vertebra, indicating a severe condition. Symptoms are more pronounced, with chronic pain, nerve impingement, and potential instability. If conservative methods fail to alleviate symptoms, surgery may be considered to correct the displacement and stabilize the spine.

Grade 5: Spondyloptosis

Grade 5 spondylolisthesis, also known as spondyloptosis, represents a complete forward displacement of the vertebra off the adjacent one. This is the most severe grade and requires immediate medical attention. Surgery is often necessary to realign the spine and relieve nerve compression.

Diagnosing Your Spondylolisthesis Grade

Properly diagnosing the grade of spondylolisthesis requires a comprehensive evaluation from a qualified healthcare professional, such as an orthopedic spine specialist or a neurosurgeon. They will conduct a thorough examination, review medical history, and may order imaging tests, such as X-rays or MRI scans, to determine the grade of spondylolisthesis affecting your spine.

Treatment Approach

The treatment approach for spondylolisthesis depends on various factors, including the grade of the condition, the presence of symptoms, and the impact on daily life. While surgery is often considered for more severe grades, conservative measures are typically recommended as initial treatment options. These may include:

  • Physical therapy exercises targeted at strengthening the core and supporting muscles
  • Non-steroidal anti-inflammatory drugs (NSAIDs) to alleviate pain and reduce inflammation
  • Hot or cold therapy to relieve muscle spasms and reduce discomfort
  • Low-impact exercises, such as swimming or cycling, to improve overall spine flexibility and strengthen surrounding muscles
  • Custom braces or supports to provide stability and reduce symptoms

If conservative treatments fail to provide sufficient relief, surgical intervention may be considered. Surgery aims to stabilize the affected vertebrae and relieve pressure on the nerves, thereby reducing pain and improving functionality.


In conclusion, spondylolisthesis grading is a crucial aspect of understanding the severity of the condition and determining an appropriate treatment plan. Whether you suspect you have grade 1, 2, 3, 4, or 5 spondylolisthesis, it is essential to seek professional evaluation for an accurate diagnosis and personalized treatment recommendations. At Regency Square Care Center, we provide valuable information to support your journey towards better spinal health. Take the first step and consult a healthcare professional today.