Can You Do Spinal Decompression With Spondylolisthesis? | San Diego, CA
If One Vertebra Has Slipped Forward, Is Spinal Decompression Safe?
If you've been diagnosed with spondylolisthesis, you may have been told that one vertebra has slipped forward relative to the vertebra below it.
Then you hear about Non-Surgical Spinal Decompression and understandably wonder:
“If my vertebra has already slipped forward, couldn't spinal decompression make it worse?”
That's an important question.
And the answer isn't simply yes or no.
For Dr. Cassidy James Boelk, DC, one of the most important considerations is whether the spondylolisthesis appears to be stable or unstable.
A patient with a stable Grade 1—or in carefully selected circumstances, a stable Grade 2—spondylolisthesis may be evaluated very differently from someone whose vertebra demonstrates significant abnormal movement.
That's why at The Spinal Decompression & Chiropractic Center of San Diego, Dr. Boelk doesn't determine candidacy based only on the grade written on an MRI report.
He wants to understand what the spine is actually doing.
Have Spondylolisthesis? Find Out If You're Actually a Candidate.
If you've been diagnosed with spondylolisthesis and are looking for nonsurgical treatment options, don't assume spinal decompression is safe for you—and don't automatically assume it isn't.
The first step is determining what type of spondylolisthesis you have and whether your spine appears sufficiently stable for treatment.
Dr. Boelk evaluates each patient individually before recommending Non-Surgical Spinal Decompression.
Find Out If You're a Candidate
📞 619-298-0800
☎️ 24/7 Answering Service
🇪🇸 Hablamos Español
📍 The Spinal Decompression & Chiropractic Center of San Diego
5095 Murphy Canyon Road, Suite 300
San Diego, CA 92123
🌐 SanDiegoBackCare.com
⭐⭐⭐⭐⭐ Looking for an Option Other Than Back Surgery
Calder had dealt with lower-back problems for more than five years and had seen six other doctors while looking for options other than surgery.
Here's what he said about his experience:
**“Dr. Boelk and his team are the best in the business! I have had lower back problems for over 5 years and been to 6 other doctors seeking options other than surgery. I came in early January not able to bend and walking with a limp. By February I was able to bend again with minimal pain and by March I am now able to bend without any pain and am able to walk normally.
I am EXTREMELY happy I did not have surgery and found Dr. Boelk. Trust him and the process and he will get you feeling better. He also said from the beginning that if at any stage in the process he felt like progress wasn't happening he would let me know which was not the case with other specialist I have seen in the past so I appreciate that.”**
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— Calder Pearce, San Diego, CA
Calder's experience highlights something particularly important for patients considering conservative treatment:
Treatment shouldn't continue simply because someone started treatment.
If you're not responding appropriately—or the findings suggest that you shouldn't receive spinal decompression in the first place—you should be told.
What Is Spondylolisthesis?
Spondylolisthesis occurs when one vertebra shifts forward relative to the vertebra below it.
The amount of slippage is commonly classified by grade.
A Grade 1 spondylolisthesis generally represents a smaller degree of forward displacement.
A Grade 2 spondylolisthesis represents a greater degree of displacement.
But here's something patients sometimes don't realize:
The grade doesn't necessarily tell you whether the vertebra is moving abnormally.
Two patients can both be told they have Grade 1 spondylolisthesis and potentially have very different clinical situations.
That's where evaluating stability becomes important.
Stable vs. Unstable Spondylolisthesis: Why Does It Matter?
Imagine looking at a single photograph of a car.
You can see exactly where the car is at that moment.
But you can't tell from that photograph whether the car is securely parked or rolling down a hill.
A standard X-ray or MRI similarly gives important information about the spine at a particular point in time.
But when stability is a concern, Dr. Boelk may also want to know:
“Does this vertebra move excessively when the patient bends forward and backward?”
That's one reason flexion and extension X-rays can be useful when clinically appropriate.
Instead of only looking at the spine in one position, these images allow the doctor to compare vertebral positioning during movement.
Why Dr. Boelk Uses Flexion and Extension X-Rays
When evaluating a patient with known or suspected spondylolisthesis, Dr. Boelk may obtain weight-bearing:
- Neutral lateral X-rays
- Flexion X-rays
- Extension X-rays
These images can help evaluate whether abnormal motion is occurring at the involved spinal segment.
And that matters because:
An unstable spondylolisthesis may completely change the treatment recommendation.
If Dr. Boelk believes a patient's spondylolisthesis is unstable or that spinal decompression would not be appropriate, he will not accept that patient for decompression treatment.
Depending on the findings, additional medical or surgical evaluation may be recommended.
Does Grade 1 Spondylolisthesis Automatically Rule Out Spinal Decompression?
No.
A diagnosis of Grade 1 spondylolisthesis by itself doesn't automatically determine candidacy in Dr. Boelk's practice.
The bigger picture matters.
That may include:
- Stability
- Symptoms
- Neurological findings
- MRI findings
- Disc condition
- Foraminal narrowing
- Spinal stenosis
- Previous treatment
- Overall clinical presentation
A patient with a stable Grade 1 spondylolisthesis may therefore be evaluated very differently from someone with substantial abnormal motion at the involved segment.
What About Grade 2 Spondylolisthesis?
Grade 2 deserves considerably more caution.
A Grade 2 slip does not mean a patient automatically qualifies for spinal decompression.
It also shouldn't be evaluated solely from the percentage of slippage written on an imaging report.
Dr. Boelk considers the entire clinical picture, with particular attention to stability and neurological findings.
Some carefully selected patients with a stable Grade 2 spondylolisthesis may potentially be considered for conservative care, while others may not be appropriate candidates.
This is exactly why candidacy should be determined individually.
What Symptoms Can Spondylolisthesis Cause?
Some people have spondylolisthesis with relatively few symptoms.
Others may experience:
- Chronic lower-back pain
- Pain with standing
- Pain with walking
- Buttock pain
- Sciatica
- Leg pain
- Numbness or tingling
- Tightness
- Symptoms aggravated by certain positions or activities
Importantly, the vertebral slip may not be the only finding.
A patient may simultaneously have:
- Disc degeneration
- Disc bulging or herniation
- Foraminal narrowing
- Spinal stenosis
- Facet degeneration
- Nerve compression
So the question isn't always simply:
“How do we treat the spondylolisthesis?”
It may be:
“Which finding is actually producing this patient's symptoms?”
⭐⭐⭐⭐⭐ Ten Years of Sciatica and Back Pain
Toni had been dealing with symptoms for years and had already tried multiple conservative approaches.
Here is her experience:
**“For the first time in 10 years, I am completely pain-free. My sciatca is gone, and I no longer have back pain.
Before finding Dr. Boelk, I tried chiropractic care, acupuncture, pain medications, and several other therapies that simply didn't work. I was one step away from back surgery when I discovered spinal decompression treatment at The Spinal Decompression & Chiropractic Center of San Diego.
The results have been incredible. Every visit was comfortable, relaxing, and completely pain-free. Dr. Boelk and Patty always took the time to explain everything and made me feel genuinely cared for throughout the process.
They are warm, welcoming, and truly dedicated to helping their patients.
Thank you, Dr. Boelk and Patty!”**
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— Toni H., San Diego, CA
Toni's experience doesn't mean every person with back pain or sciatica should receive spinal decompression.
That's precisely why the evaluation matters.
Could My Sciatica Be Related to Spondylolisthesis?
It can be.
Spondylolisthesis may contribute to narrowing around spinal nerves in some patients.
But sciatica can also result from other conditions, including disc herniation and foraminal or spinal stenosis.
That's why someone who has both spondylolisthesis and sciatica shouldn't automatically assume the vertebral slip itself explains everything.
The examination and imaging need to be considered together.
Can Non-Surgical Spinal Decompression Help?
For an appropriately selected patient with a stable spine and certain disc-related or nerve-compression conditions, Non-Surgical Spinal Decompression may be considered as part of a conservative treatment approach.
At The Spinal Decompression & Chiropractic Center of San Diego, Dr. Boelk uses the DRX9000® Non-Surgical Spinal Decompression System.
The practice has 7 DRX9000 Spinal Decompression Systems and is one of the largest known dedicated Non-Surgical Spinal Decompression practices in California.
But with spondylolisthesis especially:
Patient selection comes before treatment.
The goal isn't to put every person with back pain on a decompression table.
It's to determine whether decompression makes sense for that particular spine.
⭐⭐⭐⭐⭐ Sometimes the Right Answer Is NOT Spinal Decompression
This may be one of the most important patient experiences on this page.
Jeff came to the office after doing his own research and looking for answers about his back condition.
After his evaluation and an honest discussion with Dr. Boelk, they determined that surgery—not spinal decompression—was the appropriate option for his condition.
Jeff still left this review:
“I found this terrific practice on social media. I followed up and did my own research so I decided to pay them a visit. The place is clean, well organized and run by a very efficient receptionist. I met with the doctor and after a honest and forthright conversation, we both determined that surgery was my only option to correct my back issues. I will return as a customer when the time is right.”
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— Jeff J., Tucson, AZ
That's an important part of how Dr. Boelk approaches spondylolisthesis.
The goal of an evaluation isn't to find a reason to put you on a DRX9000.
The goal is to determine what's appropriate for you.
If Dr. Boelk doesn't believe you're a candidate for Non-Surgical Spinal Decompression, he'll tell you.
Why Patients Seek Out Dr. Cassidy James Boelk, DC
✔ Certified Spinal Decompression Doctor
✔ Certified Pain-Free Performance Specialist
✔ California X-Ray Radiology Licensed Doctor
✔ Founder, Non-Surgical Spinal Decompression Training Academy
✔ Founding Member, American Spinal Decompression Society
✔ More Than 22 Years Clinical Experience
✔ More Than 100,000 Spinal Decompression Treatments Performed
✔ 7 DRX9000® Spinal Decompression Systems
✔ One of the Largest Known Non-Surgical Spinal Decompression Practices in California
Dr. Boelk also trains other doctors in Non-Surgical Spinal Decompression protocols and techniques through the Non-Surgical Spinal Decompression Training Academy, based in his San Diego private practice.
What If I've Been Told I Need Surgery?
A surgical recommendation doesn't necessarily mean you should ignore it and seek spinal decompression instead.
There are circumstances where surgery may be appropriate.
That's particularly important when there is significant instability or progressive neurological compromise.
But if your condition is stable and you're looking for conservative options, it may be reasonable to obtain another evaluation before making your decision.
The important question isn't:
“How do I avoid surgery at all costs?”
It's:
“What is the safest and most appropriate option for my particular condition?”
Sometimes that may include conservative treatment.
Sometimes it may not.
How Do I Know If My Spondylolisthesis Is Stable?
You generally can't determine this simply by how your back feels.
And a single MRI image may not answer the entire question.
When clinically appropriate, weight-bearing flexion and extension X-rays can help evaluate how the involved vertebrae behave during movement.
Dr. Boelk may compare the spinal segment in:
Neutral → Flexion → Extension
to evaluate for abnormal motion.
That information can be extremely important when determining whether someone with spondylolisthesis should even be considered for spinal decompression.
Spondylolisthesis Evaluation in San Diego
If you've been diagnosed with Grade 1 or Grade 2 spondylolisthesis and you're wondering whether Non-Surgical Spinal Decompression could be appropriate, don't make the decision based solely on something you read online.
Have the condition properly evaluated.
Your evaluation with Dr. Cassidy James Boelk, DC may include:
✔ Review of your symptoms and health history
✔ Review of previous treatment
✔ Focused orthopedic and neurological examination
✔ Review of your existing lumbar MRI when available
✔ Weight-bearing digital X-rays when clinically indicated
✔ Flexion and extension X-rays when stability needs to be evaluated
✔ Evaluation of the spondylolisthesis and associated disc or nerve findings
✔ Determination of whether your condition appears appropriate for Non-Surgical Spinal Decompression
✔ Recommended next steps if you're not a candidate
Have Spondylolisthesis? Don't Guess About Spinal Decompression.
If you've been diagnosed with spondylolisthesis and are still struggling with back pain, sciatica, or leg symptoms, the most important question isn't simply:
“Can spinal decompression treat spondylolisthesis?”
It's:
“Is spinal decompression appropriate for MY spondylolisthesis?”
That's what the evaluation is designed to determine.
If you're looking for another opinion and want to understand whether your spondylolisthesis appears stable enough to consider Non-Surgical Spinal Decompression, we're happy to talk with you and help determine whether an evaluation makes sense.
The Spinal Decompression & Chiropractic Center of San Diego
Dr. Cassidy James Boelk, DC
Certified Spinal Decompression Doctor
Certified Pain-Free Performance Specialist
📍 5095 Murphy Canyon Road, Suite 300
San Diego, CA 92123
📞 619-298-0800
☎️ 24/7 Answering Service
🇪🇸 Hablamos Español
🌐 SanDiegoBackCare.com