[osmangony]

Listhesis itself is completely asymptomatic untill it exertes pressure on nurvous system. In many radiograph provide subjective element of having listhesis. But most of them are completely asumptomatic.

So, dont rely on radiograph somuch for clinical decession making.

In very rare situation listhesis can produce unilateral pain. So, in ur case, lets think again about symptomatic listhesis.

The clinical image shows that the patient has postero-lateral disc harniation or protrution exerting pressure on left nerve root. No matter where. Because it is not possible to say even with clear visualized herniation on MRI that this or that disc is producing symptoms. In many cases there are big protrusion with associated smaller protrution beside its level. Who can say by any objective physical examination that this disc is producing the symptom?

So, u can perform rotation manipulation of the Lx spine under manual traction. That will be safe.