Abstract
Spondylolisthesis is the anterior slippage of one vertebra on top of another. This chapter focuses on the degenerative, lumbar subtype of this condition. Risk factors include age, female gender, and African American descent. Disk degeneration leads to a series of changes culminating in spondylolisthesis. Most commonly, patients present with neurogenic claudication, which must be differentiated from vascular claudication. Imaging includes plain x-rays and MRI in most cases. Most patients improve with nonoperative treatment including activity modification, nonsteroidal anti-inflammatory medications, and physical therapy. Epidural steroid injections are commonly used but their long-term efficacy has yet to be shown. Recent investigations into operative vs. nonoperative treatment show improved outcomes with operative treatment, which most commonly involves laminectomy and posterolateral fusion with instrumentation.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Boden SD, Kang J, Sandhu H, Heller JG (2002) Use of recombinant human bone morphogenetic protein-2 to achieve posterolateral lumbar spine fusion in humans: a prospective, randomized clinical pilot trial: 2002 Volvo Award in clinical studies. Spine (Phila Pa 1976) 27:2662–2673
Epstein NE (1998) Decompression in the surgical management of degenerative spondylolisthesis: advantages of a conservative approach in 290 patients. J Spinal Disord 11:116–122; discussion 123
Fischgrund JS, Mackay M, Herkowitz HN, Brower R, Montgomery DM, Kurz LT (1997) 1997 Volvo Award winner in clinical studies. Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective, randomized study comparing decompressive laminectomy and arthrodesis with and without spinal instrumentation. Spine (Phila Pa 1976) 22:2807–2812
Glassman SD, Carreon LY, Djurasovic M, Campbell MJ, Puno RM, Johnson JR, Dimar JR (2008) RhBMP-2 versus iliac crest bone graft for lumbar spine fusion: a randomized, controlled trial in patients over sixty years of age. Spine (Phila Pa 1976) 33:2843–2849
Ha KY, Chang CH, Kim KW, Kim YS, Na KH, Lee JS (2005) Expression of estrogen receptor of the facet joints in degenerative spondylolisthesis. Spine (Phila Pa 1976) 30:562–566
Herkowitz HN, Kurz LT (1991) Degenerative lumbar spondylolisthesis with spinal stenosis. A prospective study comparing decompression with decompression and intertransverse process arthrodesis. J Bone Joint Surg Am 73:802–808
Iguchi T, Wakami T, Kurihara A, Kasahara K, Yoshiya S, Nishida K (2002) Lumbar multilevel degenerative spondylolisthesis: radiological evaluation and factors related to anterolisthesis and retrolisthesis. J Spinal Disord Tech 15:93–99
Kornblum MB, Fischgrund JS, Herkowitz HN, Abraham DA, Berkower DL, Ditkoff JS (2004) Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective long-term study comparing fusion and pseudarthrosis. Spine (Phila Pa 1976) 29:726–733; discussion 733–724
Meyerding HW (1956) Spondylolisthesis; surgical fusion of lumbosacral portion of spinal column and interarticular facets; use of autogenous bone grafts for relief of disabling backache. J Int Coll Surg 26:566–591
Sengupta DK, Herkowitz HN (2005) Degenerative spondylolisthesis: review of current trends and controversies. Spine (Phila Pa 1976) 30:S71–S81
Weinstein JN, Lurie JD, Tosteson TD, Zhao W, Blood EA, Tosteson AN, Birkmeyer N, Herkowitz H, Longley M, Lenke L, Emery S, Hu SS (2009) Surgical compared with nonoperative treatment for lumbar degenerative spondylolisthesis. Four-year results in the Spine Patient Outcomes Research Trial (SPORT) randomized and observational cohorts. J Bone Joint Surg Am 91:1295–1304
Zucherman JF, Hsu KY, Hartjen CA, Mehalic TF, Implicito DA, Martin MJ, Johnson DR 2nd, Skidmore GA, Vessa PP, Dwyer JW, Puccio ST, Cauthen JC, Ozuna RM (2005) A multicenter, prospective, randomized trial evaluating the X STOP interspinous process decompression system for the treatment of neurogenic intermittent claudication: two-year follow-up results. Spine (Phila Pa 1976) 30:1351–1358
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Koyonos, L., Rihn, J.A. (2014). Lumbar Degenerative Spondylolisthesis. In: Patel, V., Patel, A., Harrop, J., Burger, E. (eds) Spine Surgery Basics. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-34126-7_17
Download citation
DOI: https://doi.org/10.1007/978-3-642-34126-7_17
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-34125-0
Online ISBN: 978-3-642-34126-7
eBook Packages: MedicineMedicine (R0)