Typical symptoms
- Back pain triggered by movement and relieved at rest
- Locking sensation when changing position
- Buttock or leg pain that varies with posture
- Difficulty staying seated or standing for long periods
SPINE CONDITION
Vertebral instability
A back that seems to give way, that locks when you change position and aches the moment you stay upright too long — that instability often comes from one vertebra slipping on the one below (spondylolisthesis) or from worn joints letting a segment move too much. The result is mechanical back pain, sometimes with nerve compression and leg pain on top. The good news is that the unstable segment can be pinpointed and treated.
Recognising the symptoms
Instability often combines mechanical back pain with nerve symptoms. Identifying which segment is unstable is critical before considering surgery.
When to consult
- Mechanical back pain persisting beyond 3 months
- Spondylolisthesis confirmed on imaging with worsening symptoms
- Failure of structured rehabilitation
- Limitation of work or daily activity
Red flags — emergency
- New radicular pain or leg weakness
- Rapidly progressing slippage on imaging
- Loss of bladder or bowel control
- Severe pain after trauma
Causes and diagnosis
Instability has two main origins: isthmic spondylolisthesis (a stress fracture in the pars interarticularis, often originating in adolescence) and degenerative spondylolisthesis (facet joint wear in adults over 50). Both can be tolerated for years and only become symptomatic when the segment loses control.
Dynamic standing X-rays in flexion and extension are essential — they quantify motion that a single MRI cannot show. A multidisciplinary review then weighs symptoms, function and imaging before choosing between rehabilitation and surgery.
Diagnostic process
- Detailed clinical interview and segmental palpation
- Standing dynamic X-rays in flexion / extension
- MRI to assess discs, nerves and facet joints
- Bone density when fusion is contemplated
- Joint review with surgeon, anaesthetist and rehabilitation team
Treatments we offer
We always start with the least invasive option that delivers durable relief. Surgery is reserved for cases where conservative care has failed or red flags are present.
Stage 1
Deep stabilisation rehab
Specific core and gluteal training, motor control work, manual therapy and ergonomic advice. Often controls grade I slippages without surgery.
Stage 2
Decompression alone
When the segment is stable but a nerve root is compressed, a targeted microsurgical decompression resolves leg pain while preserving motion.
Stage 3
Fusion (TLIF / ALIF / OLIF)
Indicated when slippage progresses or instability is mechanical. Modern instrumented fusion uses 3D navigation, percutaneous screws and interbody cages to restore alignment with limited blood loss.
Surgical technology
Why choose Franchir
Treated in 4 to 8 weeks
Dedicated international slots reserved with our French partner surgeons — no 12 to 18 month waiting list.
3D navigation & robotics
Minimally invasive procedures, intra-operative imaging and the latest implants — often unavailable locally.
Fully bilingual pathway
Coordination from Montréal to France in French and English, with your home physician kept in the loop.
Transparent quote
Detailed pricing before any procedure, insurance support and no hidden fees.
Your journey, step by step
Step 1
Initial review
45-minute appointment with our clinical nurse specialist to review imaging, symptoms and history.
Step 2
Specialist file — 48 h
Your case is shared with the most relevant French spine surgeon. Treatment plan delivered within 48 hours.
Step 3
Travel & surgery
Concierge organises stay, transport and admission. Surgery takes place in a partner centre of excellence.
Step 4
Coordinated follow-up
Post-op recovery in Québec with shared follow-up between Franchir's team and your home physician.
Patient story
L5-S1 disc replacement: Benoît, a Quebec patient, on his new pain-free life
Benoît, a Quebec patient who received an L5-S1 disc replacement, shares his journey with Franchir and his new pain-free life.
Procedures & explainers
Live from the OR — Dynamic lumbar stabilization (TOPS) with Dr. Brauge
with Dr Brauge
L5-S1 disc replacement: a tailored care pathway to restore your mobility
Frequently asked questions
No — many grade I slippages are well tolerated for life. Surgery is considered when pain becomes disabling, when imaging shows progression, or when nerve symptoms appear despite rehabilitation.
Check your eligibility
Send us your imaging and medical history. A specialist reviews your file and confirms whether surgery is the right option — for free.