There is not simply one cause of spondylolisthesis, but rather, five main reasons why vertebral slippage may occur.

Congenital Spondylolisthesis is a condition that is present at birth and results in a defect in the facets joints. The facets are the joints connecting vertebrae that allow for spinal movements from side to side or forward and back. When these joints are incorrectly formed at birth, the facet joints are more prone to instability or fracture, which can cause spondylolisthesis.

Isthmic Spondylolisthesis is only slightly less common, and involves a defect in the part of the vertebra called the isthmus, or pars interarticularis. These pieces of bone connect the facet joints on the backside of our spine. The pars interarticularis is most prone to fracture in children between the ages of 5-7 years old, which often leads to pediatric  or adolescent spondylolisthesis.

Degenerative Spondylolisthesis can occur as a result of the aging process as bones and spinal tissues lose their integrity over time.  This condition is common. This degeneration is caused by the forces of gravity and the normal wear-and-tear that the spine accumulates over the years. Arthritis can play a factor in this degeneration. As our bones and tissues degrade, these degenerative processes leads to more chances for instability, friction, compression, and slippage.

Traumatic Spondylolisthesis occurs when an accident or sudden impact results in injury to the spine. Events such as car accidents, falls, and sports injuries can cause damage to spinal structures that may lead to vertebral slippage. Many athletes, even young children, can experience spondylolisthesis because of the quick-pivoting movements associated with sports such as gymnastics and football.

Pathologic Spondylolisthesis involves a disease or condition that leads to degeneration of the vertebrae. This can include spinal tumors or rheumatoid arthritis, both of which can lead to the progressive deterioration of spinal structures and tissues.