Spondylolisthesis (spon-duh-lo-les-THEE-sis) happens when one of the small bones in the lower back, called a vertebra, slips out of place. It usually starts with a crack or break in the bone caused by too much strain (called a stress fracture) that gets worse. Rest and physical therapy help most kids feel better, but sometimes spondylolisthesis needs surgery.

• Your child should rest as much as possible. 
• Your child can walk and go up and down stairs as usual.
• Your child should take a break from gym and sports until your health care provider gives the OK.
• Remind your child NOT to bend backward.
• If your child has pain and your health care provider says it's OK, you can give one of these medicines:
  • acetaminophen (such as Tylenol® or a store brand)
    OR
    
  • ibuprofen (such as Advil®, Motrin® or a store brand)
• If your child is uncomfortable, it might help to:
  • Place a bag of ice wrapped in a towel or washcloth on the injured area.
  • Place a heating pad wrapped in a towel on the injured area. 
• If sitting is uncomfortable, try changing positions or standing up.
• Help your child do the recommended physical therapy or exercises. 
• If your health care provider prescribed a back brace, help your child wear it as recommended. 
• If your health care provider wants your child to carry a lighter backpack, talk to the school about borrowing an extra set of books to keep at home.

Your child:

• feels tingling or weakness in the back or legs
• needs to use the bathroom a lot more often or a lot less often than usual

Your child:

• has constant, severe pain that doesn't get better with pain medicine or a change in sitting or standing positions
• loses control of urination (peeing)
• loses control of bowel movements (pooping)
• has trouble moving or controlling the lower body

How does slipping of the spine happen? When a child's growing spine (backbone) is put under repeated stress from lots of twisting or bending, one of the small bones (vertebra) in it may develop a fracture (crack). If there is a crack on both sides of one vertebra, the front of it may slip forward. Most of the time, the front slides away only a little bit. But if it slides away a lot, surgery might be needed. 

Young people have a greater chance of getting spondylolisthesis because their bones are still growing. Kids and teens who do sports and  activities that can strain the lower back or that involve a lot of leaning back are especially likely to develop it. This can include football, weightlifting, gymnastics, volleyball, ballet, golf and wrestling.

What can we do to prevent more back problems in the future? After recovery, kids and teens need to keep up with the proper techniques and sports safety measures they learned. They should keep their core muscles strong and flexible, and take breaks between sports seasons, games and competitions. Kids and teens should immediately stop doing any activity that causes back pain. They should see their health care provider and not return to play until the pain goes away.