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 


Once a patient undergoes a formal treatment program and still has issues, it’s time to evaluate if he or she is a candidate for surgery. Most of the time – nine times out of 10 – patients do not need an operation to correct their spine issues. However, in recalcitrant cases where surgery is required, we now have an array of surgery options from which to choose to accomplish our desired goals.

Why minimally invasive?

There has been an explosion in spine surgery advances, most especially in minimally invasive surgery. Continual refinement of surgical techniques and devices now allows us to perform procedures minimally invasively that in the past required large incisions, long hospitalization and lengthy recovery times.

Advantages of minimally invasive surgery:

  • Less anesthesia
  • Smaller incisions
  • Shorter operation times
  • Decreased blood loss
  • Shorter hospital stays
  • Faster recovery times
  • We’re still able to accomplish everything we were able to do in the past, but it’s safer for the patient. Minimally invasive techniques also offer solutions for patients who have had surgery in the past.

The advantages of minimally invasive surgery over traditional, open spine surgery are undeniable. We’re on the cutting edge of both learning and teaching these techniques, and I personally travel around the globe to teach these techniques to other surgeons. It is exciting work knowing we are continually making these surgeries safer for patients so they can find relief from back pain and return to their daily routines faster.

Listed below are some of the spine problems I treat, and all of these can be cared for minimally invasively if the patient should require surgery.

Spine problems treatable with MIS:

  • Sciatica
  • Herniated discs
  • Stenosis
  • Slippage/spondylolisthesis
  • Spondylosis
  • And more!

Thankfully, most patients will never have to see the inside of the operating room. But for those who do, patients can rest easy knowing they will be accurately evaluated and diagnosed, and have access to the most cutting-edge facilities, equipment, providers and surgical techniques in the country.