Can spondylolisthesis be diagnosed without an MRI?

The causes of lower back and leg pain are often complex and multi-faceted. Spondylolisthesis — a forward or backward slippage of one vertebra over an adjacent vertebra — is just one of many spinal issues that can produce these symptoms. Further complicating the matter is the many spinal conditions require different treatment approaches. All of this underscores the importance of receiving a prompt and accurate diagnosis from a qualified medical professional. In most cases, imaging studies such as X-rays or MRIs play an essential role in the diagnostic process.

How is spondylolisthesis diagnosed?

In order to reach a diagnosis of spondylolisthesis — as well as most other spinal conditions — a physician will typically complete the following steps:

  • Engage the patient in a dialogue — that covers the patient’s medical history and symptoms, including the onset, type, duration and severity of the discomfort, and what factors (if any) make it better or worsen
  • Perform a thorough physical examination — which may include reflex, nerve-function and muscle-strength testing
  • Order a diagnostic imaging test — such as an MRI, to confirm the suspected source of the pain

The role of diagnostic imaging in confirming a spondylolisthesis diagnosis

Usually, the signs of spondylolisthesis are not visually apparent during a physical examination. However, a physician can often confirm a suspected spondylolisthesis diagnosis based on X-ray images. A lateral (side-view) X-ray may reveal that a vertebra has slipped forward in relation to an adjacent vertebra, in which case an MRI may be unnecessary.

On the other hand, if a patient is experiencing pain, numbness, tingling sensations or muscle weakness in his or her legs, further imaging studies may be ordered. These symptoms could be caused by spinal nerve compression due to spondylolisthesis-related spinal stenosis, or a narrowing of the space available for nerve roots travel to the legs. An MRI or CT scan can help a physician identify nerve compression associated with spondylolisthesis.

If you’d like to discuss your spondylolisthesis diagnosis with a spine specialist, contact Laser Spine Institute. Our team can provide information on our minimally invasive outpatient surgery, which is a safer and effective alternative to traditional open spine surgery.^ Request a free MRI review* to find out if you are a candidate.