The Spine & Back Blog

What is spondylolisthesis?

Spondylolisthesis (pronounced “spon-dl-oh-lis-THEE-sis”) is a condition involving the vertebrae (bones) in your spine. In spondylolisthesis, one of the vertebrae in your spine slips out of place putting pressure on nerves and causing pain. Most often, the vertebrae in the lower spine are affected causing pain in your legs when you walk or stand for a long period of time. Some patients will experience no symptoms.

Types of spondylolisthesis:

  • Degenerative spondylolisthesis: The most common form of this disorder occurs with aging. As we age, the discs between our vertebrae wear down. This is due to the loss of water in the discs making the discs less spongy and less able to resist movement of the vertebrae. Since we all age differently, spondylolisthesis can affect patients at various ages. Degenerative spondylolisthesis occurs most often after the age of 40.
  • Isthmic spondylolisthesis: This occurs if you get a small fracture or break in your vertebrae due to an injury. The break weakens the bone to the point that it causes the vertebrae to slip out of place.
  • Congenital spondylolisthesis: This type of spondylolisthesis is present at birth and is the result of the abnormal formation of bone. This results in the abnormal arrangement of the vertebrae in the spine and puts them at a greater risk for slipping.

Spondylolisthesis Symptoms:

Many patients will experience no symptoms and may not even know they have spondylolisthesis. Low back pain is the most common symptom spreading across the lower back, resembling a muscle strain. Muscle spasms may also be present.

Spondylolisthesis can cause tightening of the hamstring muscle causing a person to walk with a shortened gait and slightly bent knees. If the nerves are affected the pain may spread down the leg and also cause numbness or tingling to occur.

Spondylolisthesis Treatment:

Spondylolisthesis is not life threatening, therefore, not everyone will require treatment for their spondylolisthesis. Treatment depends on several factors including age, the extent of the slip, severity of symptoms and the general health and well being of the person. If treatment is necessary, there are several options available.

Conservative Spondylolisthesis treatment:

  • Weight loss
  • Pain medications such as nonsteroidal anti-inflammatory medications (Advil, Ibuprofen) or oral steroids
  • Epidural steroid injections in which medication is placed directly in the space surrounding the spine
  • Ice or heat

Physical Therapy for Spondylolisthesis:

  • Stabilization exercises to strengthen the abdominal and/or back muscles

Spondylolisthesis surgery:

  • Surgery to relieve the pressure on the nerves or spinal decompression surgery
  • Surgery to restore stability or spinal fusion surgery

What can be done to prevent spondylolisthesis?

It may not be possible to prevent the occurrence of spondylothesis, but there are steps one can take to aid in the prevention.

  • Maintain a healthy weight.
  • Perform exercises to strengthen, support and stabilize your low back.
  • Chose exercises and activities that are low on impact and do not place your low back at risk or injury. For example, swimming and biking are types of low impact exercise.

Experiencing Lower Back Pain?

Neuroscience & Spine Center of the Carolinas has been helping people with neck and back pain for over 30 years. Dr. Hunter and his team always start with non-surgical pain treatments like physical therapy, acupuncture, and steroid shots. If you find that your symptoms worsen or your activities are limited, then minimally invasive surgery or and other surgical treatments are an option.

Located in Gastonia, NC, The Neuroscience & Spine Center of the Carolinas serves the greater Charlotte area.

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Many of our daily activities can be a major cause of neck and back pain. Hours spent looking down at your phone or computer can cause wear and tear on your neck. While sitting for prolonged periods of time can increase stress on your back, adding pressure to the muscles in your back, as well as, spinal discs.


  1. Man with lower back pain while working at home on his laptop at a deskDraw your shoulders back and maintain good head and neck alignment.
  2. Your gaze should be aimed comfortably at the center of your computer screen. Adjust the height of your computer screen as needed to facilitate this properly.
  3. Make sure you have a comfortable chair that allows for lumbar support of your low back.This lumbar support is essential for minimizing strain to your low back.
  4. Never slouch while sitting in your chair. This too put added pressure and strain on your low back.
  5. Get up and stand, stretch or walk 1 time every hour. If you need to, set an alarm as a reminder to get up and MOVE!

Dr. Hunter’s Low Back Exercise Program

At Neuroscience & Spine Center of the Carolinas, we want our patients to maintain good spine health and reduce neck and back pain. If you’re in need of a home exercise program for your lower back, try these exercises and keep a log of your progress.

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Are you taking New Patients?

Yes! Dr. Hunter and his providers are all able to see new patients. Please call the office or fill out this form to schedule an appointment with either Dr. Hunter, his nurse practitioner or his physician assistant.

Are you still open during the COVID-19 Pandemic?

Yes we are open. We are seeing patients in the office, as well as, through telemedicine.

How long has Dr. Hunter been practicing as a Neurosurgeon?

Dr. Hunter has been a practicing Neurosurgeon for 22 years. He has been practicing at the NSSC Spine Clinic for 20 years. He was Board Certified in Neurosurgery in 2002 and re-certified in 2012.

Are you required to have a referral?

Only if your insurance requires one. However, if you self-refer, you may be responsible for obtaining related records for treatment.

Do you treat headaches?

There are many causes of headaches. It could be from head trauma, a brain tumor, a ventricular shunt or an intracranial vascular abnormality. We see patients with headaches related to these types of issues. We do not treat or see patients for migraine headaches. Migraine headaches are usually treated by a neurologist or pain medicine doctor.

What insurances do you take?

All major plans, Aetna, BCBS, Cigna, United Healthcare, Medicare and Medicaid. Please call us to verify your insurance provider.

Are you part of Caromont?

No, we are a private practice. However, our office is in the Gaston Professional Building attached to Caromont Regional Medical Center and all surgeries are performed at Caromont Regional Medical Center. Where is your office located? We are on the 4th floor of the Gaston Professional Building.

Do I need to bring my imaging on a disc?

Yes, if not done through a Caromont Facility. We do have access to some Novant and Atrium images. Preferably, it is best to bring all information to your office visit which would include your MRI. Dr. Hunter likes to review the MRI with his patients during the office visit. Any imaging that is done at Caromont, Dr. Hunter is able to pull up the result in his office 


What are Adult Stem Cells?

Adult stem cells were discovered over 40 years ago when researchers found that cells derived from bone marrow had the ability to form various tissues. Adult stem cells are early stage cells that, under the right conditions, are capable of developing into other types of cells and hold the potential to regenerate damaged tissue.

Who is a good candidate?

Your physician will want a history of your injury and a physical examination along with any x-rays, and an MRI. While stem cell therapy may be appropriate for certain conditions, it is not applicable for every condition.  However, it has proven to be a viable option for  individuals suffering from pain.  A good candidate for adult stem cell treatment usually is:

  • A patient that wants to avoid the inherent complications that come with an invasive surgical procedure
  • A pain sufferer that is interested in an option that offers potential for an overall improved quality of life
  • A person who understands that surgery sets off a cascade of further degeneration, and is prepared to benefit from the body’s own regenerative mechanisms.
  • Every patient is different, the success of the stem cell therapy is dependent on the severity of your condition and your body’s response to stem cell therapy.

What is the procedure like?

A basic stem cell procedure lasts about 45 minutes or less. The physician will retrieve bone marrow percutaneously from the iliac crest of the hip (5 minutes). The aspirated bone marrow will then be concentrated into a smaller volume, devoid of plasma and red blood cells (12 minutes). Finally, the physician will deliver your concentrated stem cells back to the target site for regeneration.


What is the recovery period?

After a joint injection, you can typically go back to work immediately. It is advised to avoid load-bearing activities for at least 2 weeks. After a disc injection, you should rest for 2-3 days and try to stay off your feet. In any stem cell procedure, anti-inflammatory medications (NSAIDS) should be withheld for 72 hours pre-procedure and one week post-procedure.

Which Joints We Treat

  • Knee
  • Hip
  • Shoulder
  • Ankle
  • Wrist

How Do I Prepare For a Stem Cell Procedure

Before the procedure, you should not take any anti-inflammatory medications, for at least 5 days prior to the procedure. (Medications such as Advil, Aleve, Naproxen, Ibuprofen, Aspirin, etc.)

How Long Will It Take To Feel Relief And Obtain Improved Function Of The Joint

Every patient is different and it also depends on which joint or joints you have had treatment on.  Some patients have had improved mobility and pain relief in as few as 2-3 weeks.  Other patients have seen improvements at 2-3 months.

How Long Will I Feel Relief And Maintain Good Function After The Procedure

Since every patient is different, each outcome will also be different.  Studies have shown that adult stem cell treatments on joints have produced better outcomes than traditional treatments and/or surgical procedures. Stem cell therapy has helped patients to post-pone joint replacements and surgeries for many years and some patients have been able to completely avoid surgery or joint replacements all together.

Is Stem Cell Therapy FDA Approved

The bone marrow concentrate used for the treatment is drawn from your own hip using an FDA approved device.  Because your own bone marrow is used to obtain your own stem cells, the FDA requirements are met for the definition of the practice of medicine.