Spondylolisthesis — the forward slip of one vertebra over another — is graded I-V. Low-grade slips with stable mechanics frequently respond to non-surgical management focused on core strength, posture, and addressing any disc-level lesion that contributes to pain. The fibrin procedure addresses adjacent annular tears, not the slip itself.
Key Takeaways
- Spondylolisthesis is graded I-V by displacement percentage.
- Low-grade stable slips frequently respond to non-surgical management.
- Core strength and posture support the spine around the slip.
- The fibrin procedure addresses adjacent disc lesions when present.
- High-grade or progressive slips are surgical cases.
What This Guide Covers
- How is spondylolisthesis graded?
- What does non-surgical management include?
- When does the fibrin procedure help?
- When is surgery needed?
How is spondylolisthesis graded?
Grade I (under 25% slip), Grade II (25-50%), Grade III (50-75%), Grade IV (over 75%), and Grade V (complete dislocation). Stability is assessed on dynamic imaging — flexion-extension films.
What does non-surgical management include?
Non-surgical management includes core strengthening, posture correction, activity modification, and pain management. The goal is to support the spine around the slip and reduce symptomatic load.
When does the fibrin procedure help?
The procedure helps when an annular tear in an adjacent disc is contributing to pain, separate from the slip itself. The procedure does not stabilize the slip; it addresses the disc lesion.
When is surgery needed?
Surgery is needed for high-grade slips, progressive instability on serial imaging, or significant neurologic compromise. These cases require surgical stabilization.
Clinical Note
Spondylolisthesis is one of the cases where our clinical staff most reliably refers patients toward surgery when surgery fits. A Grade III or IV slip, or a progressive Grade I slip, is not a regenerative case. We say so plainly. The cases where the procedure can contribute are stable Grade I slips with disc lesions — and even those require careful imaging review.
Frequently Asked Questions
Can the procedure stop the slip from progressing?
No. Slip progression is a structural question.
If I have a Grade I slip, am I automatically a candidate?
Not automatically. Imaging must show a contributing disc lesion.
How is stability assessed?
Flexion-extension imaging shows whether the slip moves with motion.
This content is for general informational purposes only and does not constitute medical advice, diagnosis, or treatment. It is not a substitute for evaluation by a qualified physician. Treatment decisions depend on your individual medical history and clinical findings. Schedule a consultation to discuss whether the procedure is right for you.
