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Results of Surgical Treatment of Adult Degenerative Spondylolisthesis

  • Chapter
Spondylolisthesis

Abstract

The surgical treatment of adult degenerative spondylolisthesis continues to evolve. Although controversy still exists, there are several well-designed studies in recent years that have narrowed the debate on the preferred surgical treatment. Current surgical treatment strategies range from isolated nerve root decompression or a wider central decompression to decompression and fusion with or without instrumentation. While decompression alone may be appropriate in certain patient populations, decompression with fusion has demonstrated improved clinical outcomes over decompression alone in mid to long-term follow-up. However, there is no clear consensus regarding the best way to achieve fusion. Initial attempts utilizing a posterolateral fusion without instrumentation led to poor rates of arthrodesis. The advent of instrumentation has improved fusion rates by creating a more stable environment for arthrodesis to take place. This improved fusion rate appears to have afforded improved patient satisfaction, but it is not without increased risk to the patient. Current literature is focused tremendously on techniques to further improve stability. Anterior column support as well as techniques aimed at decreasing the morbidity associated with these procedures is receiving tremendous attention as are the debates to whether or not it affords improved patient outcomes. Orthobiologics (i.e., bone morphogenetic protein) are being widely utilized to augment fusion, but the literature supporting its use has recently come into question. This chapter focuses on the current literature available in the treatment of adult degenerative spondylolisthesis.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Missouri-Kansas City School of Medicine, St. Luke’s Hospital of Kansas City, Dickson-Diveley Midwest Orthopaedic Clinic, Kansas City Orthopaedic Institute, 3651 College Blvd, Leawood, KS, 66211, USA

    Theodore D. Koreckij M.D.

  2. Department of Orthopaedics, William Beaumont Hospital, Royal Oak, Michigan Orthopaedic Institute, PC, 26025 Lahser Road, 2nd Floor, Southfield, MI, 48033, USA

    Jeffrey S. Fischgrund M.D.

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  1. Theodore D. Koreckij M.D.
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  2. Jeffrey S. Fischgrund M.D.
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Correspondence to Jeffrey S. Fischgrund M.D. .

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Editors and Affiliations

  1. Assistant Professor of Orthopedic Surgery, Albert Einstein College of Medicine, New York, New York, USA

    Adam L. Wollowick

  2. Associate Professor of Orthopedic Surgery, Albert Einstein College of Medicine, Department of Orthopedic Surgery, Montefiore Medical Center, Bronx, New York, USA

    Vishal Sarwahi

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Koreckij, T.D., Fischgrund, J.S. (2015). Results of Surgical Treatment of Adult Degenerative Spondylolisthesis. In: Wollowick, A., Sarwahi, V. (eds) Spondylolisthesis. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7575-1_22

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