{"id":133,"date":"2026-06-22T15:25:23","date_gmt":"2026-06-22T15:25:23","guid":{"rendered":"https:\/\/orthonext.it\/?p=133"},"modified":"2026-10-21T22:25:23","modified_gmt":"2026-10-21T22:25:23","slug":"spondilolistesi","status":"publish","type":"post","link":"https:\/\/orthonext.it\/en\/spondilolistesi\/","title":{"rendered":"Spondilolistesi: Sintomi e Trattamenti"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"133\" class=\"elementor elementor-133\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-ebe250a elementor-section-full_width elementor-section-height-default elementor-section-height-default\" data-id=\"ebe250a\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-17c6688\" data-id=\"17c6688\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1a19893 elementor-widget elementor-widget-html\" data-id=\"1a19893\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t\t<!-- Ortho-Next | Spondilolistesi | https:\/\/orthonext.it\/spondilolistesi\/ (esistente) | snippet autonomo: HTML + CSS + JS. 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h1{font-size:32px}.onx-app__hero{padding:22px 18px;gap:24px}.onx-app__hero p{font-size:16px}.onx-phones{gap:12px}.onx-phone{width:128px;border-radius:22px;padding:6px}.onx-phone img{border-radius:17px}.onx-phone--lg{width:146px}\n.onx-store b{font-size:16px}.onx-store{padding:8px 10px}\n.onx-phones .onx-phone:nth-child(3){display:none}\n.onx-feat{grid-template-columns:1fr 1fr;gap:18px 12px}.onx-feat .onx-phone{width:100%;max-width:170px}.onx-feat figcaption h3{font-size:17px}.onx-feat figcaption p{font-size:13.5px}\n.onx-store{min-width:0;flex:1 1 150px}\n}\n.page-header{display:none!important}.page-content>.onx-scope,.elementor-widget-html .onx-scope{margin-top:0}\n<\/style>\n<div class=\"onx-scope\">\n<nav class=\"onx-patnav onx-patnav--top\" aria-label=\"Menu patologie\"><div class=\"onx-patnav__row\"><span class=\"onx-patnav__label\">Patologie e interventi<\/span><details class=\"onx-dd\"><summary aria-label=\"Apri il menu Patologie\">Patologie <span class=\"onx-dd__chev\" aria-hidden=\"true\">&#9662;<\/span><\/summary><div class=\"onx-dd__panel\"><div><p class=\"onx-dd__group\">Patologie della colonna<\/p><ul><li><a href=\"https:\/\/orthonext.it\/ernia-del-disco-sintomi-e-trattamenti\/\">Ernia del disco<small>Sciatica, formicolio, microdiscectomia<\/small><\/a><\/li><li><a href=\"https:\/\/orthonext.it\/stenosi-lombare-sintomi-e-trattamenti\/\">Stenosi lombare<small>Gambe pesanti camminando<\/small><\/a><\/li><li><a href=\"https:\/\/orthonext.it\/spondilolistesi\/\" aria-current=\"page\">Spondilolistesi<small>Vertebra che scivola<\/small><\/a><\/li><li><a href=\"https:\/\/orthonext.it\/scoliosi-sintomi-e-trattamenti\/\">Scoliosi<small>Ragazzi e adulti<\/small><\/a><\/li><li><a href=\"https:\/\/orthonext.it\/cervicobrachialgia-sintomi-e-trattamenti\/\">Cervicobrachialgia<small>Dal collo al braccio, mielopatia<\/small><\/a><\/li><li><a href=\"https:\/\/orthonext.it\/osteoporosi-vertebroplastica\/\">Fratture e osteoporosi<small>Vertebroplastica, MOC, cura dell&#x27;osso<\/small><\/a><\/li><\/ul><\/div><div><p class=\"onx-dd__group\">Interventi<\/p><ul><li><a href=\"https:\/\/orthonext.it\/endoscopia-vertebrale-biportale\/\">Endoscopia vertebrale<small>Biportale, due piccoli accessi<\/small><\/a><\/li><li><a href=\"https:\/\/orthonext.it\/artrodesi-lombare-tlif-xlif-alif\/\">Artrodesi lombare<small>TLIF, XLIF, ALIF<\/small><\/a><\/li><li><a href=\"https:\/\/orthonext.it\/artrodesi-cervicale-anteriore-acdf\/\">Artrodesi cervicale<small>ACDF al microscopio<\/small><\/a><\/li><\/ul><\/div><p class=\"onx-dd__all\"><a href=\"https:\/\/orthonext.it\/patologie\/\">Tutte le patologie e i video &#8594;<\/a><\/p><\/div><\/details><div class=\"onx-pills\"><a href=\"https:\/\/orthonext.it\/ernia-del-disco-sintomi-e-trattamenti\/\">Ernia del disco<\/a><a href=\"https:\/\/orthonext.it\/stenosi-lombare-sintomi-e-trattamenti\/\">Stenosi lombare<\/a><a href=\"https:\/\/orthonext.it\/spondilolistesi\/\" aria-current=\"page\">Spondilolistesi<\/a><a href=\"https:\/\/orthonext.it\/scoliosi-sintomi-e-trattamenti\/\">Scoliosi<\/a><a href=\"https:\/\/orthonext.it\/cervicobrachialgia-sintomi-e-trattamenti\/\">Cervicobrachialgia<\/a><a href=\"https:\/\/orthonext.it\/osteoporosi-vertebroplastica\/\">Fratture e osteoporosi<\/a><a href=\"https:\/\/orthonext.it\/endoscopia-vertebrale-biportale\/\">Endoscopia vertebrale<\/a><a href=\"https:\/\/orthonext.it\/artrodesi-lombare-tlif-xlif-alif\/\">Artrodesi lombare<\/a><a href=\"https:\/\/orthonext.it\/artrodesi-cervicale-anteriore-acdf\/\">Artrodesi cervicale<\/a><\/div><\/div><\/nav>\n<article class=\"onx-article\">\n<p class=\"onx-kicker\">Patologie &#183; Chirurgia vertebrale &#183; Lainate<\/p><h1>Spondilolistesi: quando una vertebra scivola<\/h1>\n<p class=\"onx-lead\">La parola &quot;spondilolistesi&quot; unisce &quot;spondilo&quot; (vertebra) e &quot;olistesi&quot; (scivolamento): una vertebra scivola in avanti rispetto a quella sottostante.<\/p>\n<figure class=\"onx-hero\"><img decoding=\"async\" src=\"https:\/\/orthonext.it\/wp-content\/uploads\/2026\/10\/onx-pat-spondilolistesi.jpg\" alt=\"Infografica: spondilolistesi\" loading=\"lazy\"><\/figure>\n<nav class=\"onx-toc\" aria-label=\"Indice\"><strong>In questa pagina<\/strong><ol><li><a href=\"#onx-s1\">Classificazione<\/a><\/li><li><a href=\"#onx-s2\">Le cause<\/a><\/li><li><a href=\"#onx-s3\">I sintomi principali<\/a><\/li><li><a href=\"#onx-s4\">Come si fa la diagnosi<\/a><\/li><li><a href=\"#onx-s5\">Come si cura senza intervento<\/a><\/li><li><a href=\"#onx-s6\">Quando si valuta l&#x27;artrodesi<\/a><\/li><li><a href=\"#onx-s7\">L&#x27;intervento<\/a><\/li><li><a href=\"#onx-video\">Video del Dott. Lavanga<\/a><\/li><li><a href=\"#onx-refs\">Riferimenti<\/a><\/li><\/ol><\/nav>\n<section class=\"onx-sec\" id=\"onx-s1\"><h2>Classificazione<\/h2><p>Si classifica in base al grado di scivolamento secondo <strong>Meyerding<\/strong>:<\/p><ul><li><strong>Grado 1:<\/strong> scivolamento fino al 25%<\/li><li><strong>Grado 2:<\/strong> 25&#8211;50%<\/li><li><strong>Grado 3:<\/strong> 50&#8211;75%<\/li><li><strong>Grado 4:<\/strong> oltre il 75%; lo scivolamento completo si chiama spondiloptosi<\/li><\/ul><\/section>\n<section class=\"onx-sec\" id=\"onx-s2\"><h2>Le cause<\/h2><ul><li><strong>Istmica:<\/strong> per un'interruzione dell'istmo vertebrale (spondilolisi), spesso presente fin dall'adolescenza, pi&#249; frequente a L5-S1.<\/li><li><strong>Degenerativa:<\/strong> legata all'invecchiamento di disco e faccette articolari, pi&#249; frequente a L4-L5 e nelle donne dopo i 50 anni.<\/li><li><strong>Congenita<\/strong> o <strong>traumatica<\/strong>.<\/li><li><strong>Patologica:<\/strong> da malattie dell'osso o del tessuto connettivo.<\/li><\/ul><\/section>\n<section class=\"onx-sec\" id=\"onx-s3\"><h2>I sintomi principali<\/h2><p>La spondilolistesi pu&#242; essere <strong>asintomatica<\/strong>, soprattutto negli sportivi. Quando d&#224; disturbi, i pi&#249; comuni sono:<\/p><ul><li>dolore lombare che pu&#242; irradiarsi a glutei e gambe;<\/li><li>rigidit&#224; e tensione dei muscoli lombari;<\/li><li>sciatalgia, formicolio e intorpidimento;<\/li><li>fatica a camminare, come nella <a href=\"https:\/\/orthonext.it\/stenosi-lombare-sintomi-e-trattamenti\/\">stenosi lombare<\/a>, quando lo scivolamento restringe il canale.<\/li><\/ul><\/section>\n\n<section class=\"onx-sec\" id=\"onx-s4\"><h2>Come si fa la diagnosi<\/h2><p>Dopo la visita, le <strong>radiografie in piedi<\/strong>, comprese quelle in flessione ed estensione, misurano il grado di scivolamento e mostrano se il segmento si muove in modo anomalo. La <strong>risonanza<\/strong> valuta dischi e nervi; la <strong>TC<\/strong> &#232; utile per vedere la lisi dell'istmo. La diagnosi e la gestione conservativa della forma degenerativa sono riassunte in una revisione dedicata <a class=\"onx-cite\" href=\"#onx-ref-1\" title=\"Kalichman 2008 &#8211; PMID 18026865\">[1]<\/a>.<\/p><\/section>\n<section class=\"onx-sec\" id=\"onx-s5\"><h2>Come si cura senza intervento<\/h2><ul><li><strong>Accertamento medico<\/strong> per capire se la condizione &#232; in evoluzione e pianificare il percorso.<\/li><li><strong>Fisioterapia<\/strong> mirata a forza ed elasticit&#224; dei muscoli del tronco.<\/li><li><strong>Correzione posturale<\/strong> nelle attivit&#224; quotidiane.<\/li><li><strong>Terapia farmacologica<\/strong> per i sintomi.<\/li><\/ul><p>La spondilolistesi non &#232; una condizione \"tutto o nulla\": con una diagnosi precoce e una gestione adeguata si pu&#242; mantenere una vita attiva.<\/p><\/section>\n<section class=\"onx-sec\" id=\"onx-s6\"><h2>Quando si valuta l&#x27;artrodesi<\/h2><p>Si considera l'intervento quando dolore alle gambe, claudicatio o deficit neurologici persistono nonostante le cure, o quando lo scivolamento progredisce. Nello studio SPORT i pazienti operati per spondilolistesi degenerativa hanno avuto risultati migliori a due anni rispetto a quelli trattati senza chirurgia <a class=\"onx-cite\" href=\"#onx-ref-2\" title=\"Weinstein 2007 &#8211; PMID 17538085\">[2]<\/a>. Nella spondilolistesi degenerativa di grado 1, aggiungere l'artrodesi alla laminectomia ha dato un miglioramento modesto ma clinicamente significativo della qualit&#224; di vita fisica <a class=\"onx-cite\" href=\"#onx-ref-3\" title=\"Ghogawala 2016 &#8211; PMID 27074067\">[3]<\/a>, mentre un altro studio randomizzato non ha trovato vantaggi dell'artrodesi aggiunta in pazienti con stenosi, con o senza spondilolistesi <a class=\"onx-cite\" href=\"#onx-ref-4\" title=\"F&#246;rsth 2016 &#8211; PMID 27074066\">[4]<\/a>. La scelta va quindi personalizzata, valutando soprattutto la mobilit&#224; anomala del segmento.<\/p><\/section>\n<section class=\"onx-sec\" id=\"onx-s7\"><h2>L&#x27;intervento<\/h2><p>Quando indicata, l'<a href=\"https:\/\/orthonext.it\/artrodesi-lombare-tlif-xlif-alif\/\">artrodesi lombare<\/a> libera i nervi compressi, ripristina l'altezza del disco con una gabbia intersomatica e blocca il segmento con viti peduncolari e barre fino alla fusione dell'osso. Le tecniche (TLIF, XLIF, ALIF) si scelgono in base al livello e all'anatomia del paziente.<\/p><\/section>\n<section class=\"onx-videos\" id=\"onx-video\"><h2>Video del Dott. Lavanga<\/h2><div class=\"onx-vgrid\"><div class=\"onx-yt\" data-yt=\"y53mupmdaJ8\" data-title=\"Il caso di una spondilolistesi istmica operata sei mesi prima\"><button type=\"button\" class=\"onx-yt__btn\" aria-label=\"Riproduci il video: Il caso di una spondilolistesi istmica operata sei mesi prima\"><img loading=\"lazy\" src=\"https:\/\/orthonext.it\/wp-content\/uploads\/2026\/10\/onx-yt-y53mupmdaj8.jpg\" alt=\"\" loading=\"lazy\" decoding=\"async\" width=\"480\" height=\"360\"><span class=\"onx-yt__play\" aria-hidden=\"true\"><\/span><span class=\"onx-yt__dur\">1:10<\/span><\/button><p class=\"onx-yt__title\">Il caso di una spondilolistesi istmica operata sei mesi prima<\/p><\/div><div class=\"onx-yt\" data-yt=\"IaWPpZSbbKs\" data-title=\"Artrodesi e decompressione: che cosa si fa in pratica\"><button type=\"button\" class=\"onx-yt__btn\" aria-label=\"Riproduci il video: Artrodesi e decompressione: che cosa si fa in pratica\"><img loading=\"lazy\" src=\"https:\/\/orthonext.it\/wp-content\/uploads\/2026\/10\/onx-yt-iawppzsbbks.jpg\" alt=\"\" loading=\"lazy\" decoding=\"async\" width=\"480\" height=\"360\"><span class=\"onx-yt__play\" aria-hidden=\"true\"><\/span><span class=\"onx-yt__dur\">1:25<\/span><\/button><p class=\"onx-yt__title\">Artrodesi e decompressione: che cosa si fa in pratica<\/p><\/div><\/div><p class=\"onx-yt__note\">I video si caricano da YouTube (youtube-nocookie.com) solo quando premi &#9654;.<\/p><\/section>\n<aside class=\"onx-cta\"><div><h2>Prenota una visita con il Dott. Vito Lavanga<\/h2><p>Ortho-Next, Viale Rimembranze 43, Lainate (MI), anche in telemedicina. Scrivici su WhatsApp al <strong>392 39 91 841<\/strong>.<\/p><\/div><div class=\"onx-cta__btns\"><a class=\"onx-btn onx-btn--y\" href=\"https:\/\/wa.me\/393923991841?text=Buongiorno%2C%20vorrei%20prenotare%20una%20visita%20con%20il%20Dott.%20Lavanga\" target=\"_blank\" rel=\"noopener\">WhatsApp 392 39 91 841<\/a><a class=\"onx-btn onx-btn--w\" href=\"https:\/\/wa.me\/393315032553?text=GUIDA\" target=\"_blank\" rel=\"noopener\">Guida gratuita: scrivi GUIDA<\/a><\/div><\/aside>\n<div class=\"onx-author\"><div class=\"onx-author__ico\" aria-hidden=\"true\">VL<\/div><div><strong>Dott. Vito Lavanga<\/strong>, ortopedico e chirurgo della colonna vertebrale, oltre 2.300 interventi. Riceve a Ortho-Next, Lainate, e nelle altre sedi in cui opera.<\/div><\/div>\n<h2 style=\"font-size:24px\">Approfondimenti correlati<\/h2><div class=\"onx-related\"><a href=\"https:\/\/orthonext.it\/stenosi-lombare-sintomi-e-trattamenti\/\">Stenosi lombare<small>Gambe pesanti camminando<\/small><\/a><a href=\"https:\/\/orthonext.it\/artrodesi-lombare-tlif-xlif-alif\/\">Artrodesi lombare<small>TLIF, XLIF, ALIF<\/small><\/a><a href=\"https:\/\/orthonext.it\/ernia-del-disco-sintomi-e-trattamenti\/\">Ernia del disco<small>Sciatica, formicolio, microdiscectomia<\/small><\/a><\/div>\n<section class=\"onx-refs\" id=\"onx-refs\"><h2>Riferimenti scientifici (PubMed)<\/h2><ol><li id=\"onx-ref-1\">Kalichman L et al. Diagnosis and conservative management of degenerative lumbar spondylolisthesis. Eur Spine J. 2008. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18026865\/\" target=\"_blank\" rel=\"noopener\">PMID 18026865<\/a><\/li><li id=\"onx-ref-2\">Weinstein JN et al. Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis. N Engl J Med. 2007. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/17538085\/\" target=\"_blank\" rel=\"noopener\">PMID 17538085<\/a><\/li><li id=\"onx-ref-3\">Ghogawala Z et al. Laminectomy plus Fusion versus Laminectomy Alone for Lumbar Spondylolisthesis. N Engl J Med. 2016. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27074067\/\" target=\"_blank\" rel=\"noopener\">PMID 27074067<\/a><\/li><li id=\"onx-ref-4\">F&#246;rsth P et al. A Randomized, Controlled Trial of Fusion Surgery for Lumbar Spinal Stenosis. N Engl J Med. 2016. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27074066\/\" target=\"_blank\" rel=\"noopener\">PMID 27074066<\/a><\/li><\/ol><p class=\"onx-disclaimer\">Contenuto informativo: non sostituisce la visita medica, la diagnosi o una terapia personalizzata.<\/p><\/section>\n<\/article>\n<nav class=\"onx-patnav onx-patnav--bottom\" aria-label=\"Altre patologie\"><p class=\"onx-patnav__title\">Continua a leggere<\/p><div class=\"onx-patnav__row\"><span class=\"onx-patnav__label\">Patologie e interventi<\/span><details class=\"onx-dd onx-dd--up\"><summary aria-label=\"Apri il menu Patologie\">Patologie <span class=\"onx-dd__chev\" aria-hidden=\"true\">&#9662;<\/span><\/summary><div class=\"onx-dd__panel\"><div><p class=\"onx-dd__group\">Patologie della colonna<\/p><ul><li><a href=\"https:\/\/orthonext.it\/ernia-del-disco-sintomi-e-trattamenti\/\">Ernia del disco<small>Sciatica, formicolio, microdiscectomia<\/small><\/a><\/li><li><a href=\"https:\/\/orthonext.it\/stenosi-lombare-sintomi-e-trattamenti\/\">Stenosi lombare<small>Gambe pesanti camminando<\/small><\/a><\/li><li><a href=\"https:\/\/orthonext.it\/spondilolistesi\/\" aria-current=\"page\">Spondilolistesi<small>Vertebra che scivola<\/small><\/a><\/li><li><a href=\"https:\/\/orthonext.it\/scoliosi-sintomi-e-trattamenti\/\">Scoliosi<small>Ragazzi e adulti<\/small><\/a><\/li><li><a href=\"https:\/\/orthonext.it\/cervicobrachialgia-sintomi-e-trattamenti\/\">Cervicobrachialgia<small>Dal collo al braccio, mielopatia<\/small><\/a><\/li><li><a href=\"https:\/\/orthonext.it\/osteoporosi-vertebroplastica\/\">Fratture e osteoporosi<small>Vertebroplastica, MOC, cura dell&#x27;osso<\/small><\/a><\/li><\/ul><\/div><div><p class=\"onx-dd__group\">Interventi<\/p><ul><li><a href=\"https:\/\/orthonext.it\/endoscopia-vertebrale-biportale\/\">Endoscopia vertebrale<small>Biportale, due piccoli accessi<\/small><\/a><\/li><li><a href=\"https:\/\/orthonext.it\/artrodesi-lombare-tlif-xlif-alif\/\">Artrodesi lombare<small>TLIF, XLIF, ALIF<\/small><\/a><\/li><li><a href=\"https:\/\/orthonext.it\/artrodesi-cervicale-anteriore-acdf\/\">Artrodesi cervicale<small>ACDF al microscopio<\/small><\/a><\/li><\/ul><\/div><p class=\"onx-dd__all\"><a href=\"https:\/\/orthonext.it\/patologie\/\">Tutte le patologie e i video &#8594;<\/a><\/p><\/div><\/details><div class=\"onx-pills\"><a href=\"https:\/\/orthonext.it\/ernia-del-disco-sintomi-e-trattamenti\/\">Ernia del disco<\/a><a href=\"https:\/\/orthonext.it\/stenosi-lombare-sintomi-e-trattamenti\/\">Stenosi lombare<\/a><a href=\"https:\/\/orthonext.it\/spondilolistesi\/\" aria-current=\"page\">Spondilolistesi<\/a><a href=\"https:\/\/orthonext.it\/scoliosi-sintomi-e-trattamenti\/\">Scoliosi<\/a><a href=\"https:\/\/orthonext.it\/cervicobrachialgia-sintomi-e-trattamenti\/\">Cervicobrachialgia<\/a><a href=\"https:\/\/orthonext.it\/osteoporosi-vertebroplastica\/\">Fratture e osteoporosi<\/a><a href=\"https:\/\/orthonext.it\/endoscopia-vertebrale-biportale\/\">Endoscopia vertebrale<\/a><a href=\"https:\/\/orthonext.it\/artrodesi-lombare-tlif-xlif-alif\/\">Artrodesi lombare<\/a><a href=\"https:\/\/orthonext.it\/artrodesi-cervicale-anteriore-acdf\/\">Artrodesi cervicale<\/a><\/div><\/div><div class=\"onx-patnav__pn\"><a href=\"https:\/\/orthonext.it\/stenosi-lombare-sintomi-e-trattamenti\/\"><small>&#8249; Precedente<\/small>Stenosi lombare<\/a><a class=\"onx-next\" href=\"https:\/\/orthonext.it\/scoliosi-sintomi-e-trattamenti\/\"><small>Successiva &#8250;<\/small>Scoliosi<\/a><\/div><\/nav>\n<\/div>\n<script>\n\/* Ortho-Next - 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