01 — What it is
A slip can follow a stress fracture in the bony bridge behind the disc, which is seen in younger athletes, or arthritis of the facet joints in older adults. What matters clinically is whether the segment moves abnormally and whether that movement is compressing nerves, rather than the size of the slip alone.
02 — Symptoms
- Back pain that is worse standing and better sitting
- Leg pain and heaviness with walking
- A sense that the back needs support
- Hamstring tightness and altered gait in younger patients
03 — Causes
- Stress fracture of the pars from repetitive extension in sport
- Degenerative facet arthritis
- Trauma
- Prior decompression that affected the facet joints
04 — How it is diagnosed
Standing flexion and extension X-rays are important here, because a slip that reduces when lying down may not be apparent on MRI. CT defines a pars defect. MRI shows the nerve compression.
05 — Treatment approach
Low-grade slips without neurological symptoms are commonly managed without surgery. Where surgery is appropriate, the segment is decompressed and stabilized, with attention to restoring alignment rather than fixing the spine in the position it has settled into.
General information only. Your own diagnosis and plan depend on your examination and imaging. Nothing here replaces a consultation.
