Can You Get Disability for Spondylolisthesis, Retrolisthesis, or Laterolisthesis?

Spondylolisthesis, retrolisthesis, and laterolisthesis all relate to a disorder of the spine that can cause the type of back pain that can prevent you from working. If your doctor has told you that you have spondylolisthesis, retrolisthesis, or laterolisthesis, you probably have lots of questions. If you've stopped working, you might want to know if you qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) as a result of your diagnosis.

What Are Spondylolisthesis, Retrolisthesis, and Laterolisthesis?

Spondylolisthesis (spawn-duh-low-less-THEE-sis) is a disorder of your back or neck in which one of the bones that make up your spine slips onto the bone below it. Sometimes, this bone (called a vertebra) can put pressure on one of the many nerves that run up and down your spine, bringing messages from your spinal column to the rest of your body. Pressure on the nerve can cause pain in the area of the body that the nerve connects to, such as the lower back or legs, or the neck or arms.

Spondylolisthesis is often used to refer to any type of slippage of the spinal vertebrae, regardless of direction. It comes from the Greek words "spondylos" meaning "spine," and "listhesis," meaning "sliding or slipping." You might have received a more specific diagnosis that specifies in which direction your vertebra has moved. For example, if you've been told that you have retrolisthesis, it means that a vertebra has slipped backward onto another. If your diagnosis is laterolisthesis, or "lateral listhesis," it means that a vertebra has moved sideways. Lateral listhesis can be caused by scoliosis.

What Causes Spondylolisthesis, Retrolisthesis, and Laterolisthesis?

Spondylolisthesis can occur for several reasons. One cause is simply degeneration due to aging. Wear and tear on the vertebrae can cause them to slide out of place. For people over the age of 50, spondylolisthesis often occurs with other degenerative diseases of the spine, such as facet joint arthritis. The facet joints connect the larger vertebrae in your back and are made of cartilage, a firm tissue that is softer and more flexible than bone. If the cartilage that makes up your facet joints is eroded from arthritis, a nearby vertebra may slip and cause pain.

Genes can also play a role in causing spondylolisthesis. If you've received a diagnosis of isthmic (IZ-mik) spondylolisthesis, it means you were born with a thinner than normal section of your vertebra called the pars interarticularis. This piece of bone links your facet joints to the vertebrae directly above and below. When these bones are thinner than usual, they're more likely to fracture and slip.

Other types of spondylolisthesis have different causes:

• traumatic spondylolisthesis happens when an injury, such as a car accident, causes a vertebra to slip
• congenital spondylolisthesis happens when your spine doesn't form the way it should before birth, and
• post-surgical spondylolisthesis can be a result of spinal surgery.

What Are the Symptoms of Vertebral Listhesis?

Not everybody with spondylolisthesis, retrolisthesis, or laterolisthesis will experience symptoms. Some people have the condition and don't even know it. But when symptoms do occur, they can be painful and can prevent you from doing activities that you previously had no trouble with. Pain in your lower back is the most common symptom of spondylolisthesis. Other symptoms can include:

• muscle spasms in the back of your thighs
• stiffness in your back
• difficulty with walking or standing
• pain when sitting or bending over, and
• numbness, weakness, or tingling in your foot.

How Does Social Security Determine If Your Spondylolisthesis Is Disabling?

The Social Security Administration can find you disabled "medically" or "vocationally." Medical disability means that your medical records have evidence of symptoms or test results that Social Security has already determined are enough to find you disabled under its "listing" of disorders. If you're approved through a vocational allowance, that means Social Security has found that your particular limitations make it impossible for you to do any job.

Qualifying Under the Medical Listing for Skeletal Spine Disorders

Social Security doesn't specifically name spondylolisthesis, laterolisthesis, or retrolisthesis as one of the "listed" disorders that get you automatically approved. But the agency does provide a listing (1.15) for spinal disorders that result in "compromise of a nerve root." Since spondylolisthesis often appears with other spinal conditions, you may qualify as medically disabled under that listing if you can show, through your medical record, that all of the following are true:

• You feel pain, numbness, or fatigue in the part of your body affected by the nerve that your slipped vertebra is touching.
• A doctor has examined you and found weakness, irritation, and decreased sensation in that part of your body.
• You have an MRI, X-ray, or CT Scan showing that your bone is touching a nerve, and
• A doctor has prescribed you an assistive device, like a walker or a wheelchair.

If you think you qualify for disability based on listing 1.15, try to get a "medical source statement" from your doctor. It's especially helpful to get a statement from a doctor who has special knowledge about your history with spondylolisthesis—for example, an orthopedic surgeon you've seen for several years. The doctor's statement should specifically address the limitations described by listing 1.15, like any difficulty you have walking without an aid.

Qualifying Vocationally: If You Don't Meet the Medical Listing

Since degenerative spondylolisthesis can be progressive, you might be at a stage where your limitations aren't yet severe enough to meet the requirements of the above listing. Still, your symptoms might be serious enough to prevent you from working. In this case, Social Security can find you disabled "vocationally" if the agency concludes that there are no jobs available (anywhere in the country) that you can perform.

Does Your Condition Interfere With Daily Activities?

To decide whether you can work any jobs, Social Security will be interested in the ways that your symptoms interfere with your activities of daily living ("ADLs"). Social Security asks about your ADLs because it makes sense that something you have difficulty with at home would be something you would struggle with at work.

For example, if you feel pain in your lower back or legs after walking to the mailbox and back, it makes sense that you'd struggle to do a job where you'd have to walk around all day. Or if you have listhesis in your cervical spine, and you fumble with zippers and buttons while getting dressed, you probably wouldn't do well at a job where you had to handle small objects like screws.

What's the Most You Can Do Despite Your Limitations?

You aren't expected to do a job that's beyond your capabilities, mentally or physically. The process Social Security uses to figure out what work activities are within your capabilities is called assessing your "residual functional capacity" (RFC). Your RFC is a list of the most intensive work you can do despite your limitations.

To prove that there are no jobs within your RFC, you must first show that your RFC prevents you from returning to any of the jobs you've performed in the past. Depending on your age, education, and skills, you will also likely have to show that there are no other jobs that are less demanding, physically or mentally, that you could do. For more information, see our article on getting vocationally approved for disability benefits.

How Does Spondylolisthesis, Retrolisthesis, and Laterolisthesis Get Diagnosed?

Your doctor will want to run some tests to determine the type of spondylolisthesis you have, how severe your condition is, and whether you have any additional conditions affecting your back.

First, your doctor will likely conduct a physical examination. This involves examining your back and looking for areas of tenderness, limited range of motion, muscle spasms, and muscle weakness.

Your doctor may also order imaging tests, such as an X-ray, MRI, or CT scan. An X-ray helps your doctor see if there is a vertebra out of place. A CT (computerized tomography) or MRI (magnetic resonance imaging) scan can let your doctor see if there is damage to nerves or tissue, such as facet joints. A nerve conduction study (NCS) lets your doctor see if the affected vertebra is preventing nerve signals from traveling to your legs or feet.

What's the Treatment for Spondylolisthesis?

Treatment for spondylolisthesis will depend on how severe your condition is. Sometimes, you might be able to manage your symptoms with nonsurgical treatments. Typical treatments that don't involve surgery include:

• Medication. Your doctor may recommend over-the-counter pain relievers, such as Tylenol or Ibuprofen, or prescribe medications, such as Neurontin (gabapentin). In very severe cases, your doctor may prescribe an opioid, such as Vicodin (hydrocodone) or Percocet (oxycodone).

• Epidural steroid injections. Your doctor, or a specialist, might inject a pain reliever and steroid directly into the space surrounding the spinal cord and nerve roots. The goal is to control pain by reducing inflammation around the nerve roots.

• Physical therapy. A physical therapist can teach you targeted exercises to strengthen your belly and back. This can relieve pain and increase your mobility.

• Lumbar brace. A brace will compress your abdomen and take some of the pressure off your spinal column.

• TENS (transcutaneous electrical nerve stimulation) unit. Your physical therapist may use this machine to stimulate your muscles through variable, but safe, intensities of electrical current. It can help reduce any muscle spasms you may have, and may increase your body's production of endorphins, your natural painkillers. If your pain is severe enough, your doctor might prescribe you a TENS unit to use at your home.

If you've tried most or all of the above treatments and you're still experiencing pain, your doctor may recommend surgery. A typical surgery for spondylolisthesis is spinal decompression. During decompression surgery, your surgeon removes bone or tissue, which gives the nerves space inside the spinal canal, relieving pain.

Another common back surgery is spinal fusion. For a fusion surgery, your surgeon connects the bones that have slipped and are causing pain. As they heal, they form into one bone, eliminating movement between the two vertebrae and preventing them from slipping again. If you've had a spinal fusion, you might find that you have reduced flexibility in your back as a result.

Documenting Listhesis: What Social Security Looks for in Your Application

Having medical documentation of your spondylolisthesis, retrolisthesis, or laterolisthesis is very important. When disability claims examiners review applications, they start by looking at your medical records. You'll want to let Social Security know the dates and locations of all doctor visits and any medical treatment you've been receiving related to your spondylolisthesis.

Ideally, your medical records will include most, if not all, of the following:

• Imaging, such as an X-ray or MRI, documenting that you have spondylolisthesis and showing how severe it is.
• Notes from your doctor's visits showing abnormalities on physical examination, like if you had trouble getting on or off the examination table.
• Medications that your doctors have prescribed for you, showing if they've been helping or not, and any side effects you might get from them.
• Use of nonsurgical treatments, like a TENS unit or steroid injections.
• Referrals to any specialists, like an orthopedic surgeon or a neurologist, and what those specialists have said about your spondylolisthesis.
• Physical therapy records that help show your limitations in activities like lifting weight and bending over.
• Visits to the emergency department for back pain.
• Surgical records, if you've had a spinal decompression and/or fusion.

Don't worry if your medical records don't contain every single item above. If you're missing anything, Social Security will consider whether there's a good reason why, such as not having insurance to pay for treatment.

How Do I Apply for Disability Benefits for Spondylolisthesis?

One way to get your disability application started is to file online with the Social Security Administration (SSA). You don't have to complete the application all at once; just make sure that you write down the application number given to you when you start the application so you can get back into the application if you need to come back to it.

You can also apply for disability benefits by phone by calling 800-772-1213 from 8 a.m. to 5:30 p.m. Monday through Friday. If you're deaf or hard of hearing, you can call the TTY number at 800-325-0778.

Finally, you can apply for disability benefits in person at your local Social Security field office. You can locate your field office here. (Please note that this option can involve lengthy waiting and COVID-19 precautions.)

If you'd like help with your application, think about working with an SSDI expert. According to a survey of our readers, applicants who filed an initial application without expert help were denied 80% of the time. Consider having a consultation with a legal professional to determine whether your spondylolisthesis or retrolisthesis qualifies for benefits.

_{Published February 18, 2022}