Skip to main content
SpringerLink
Log in

Classification of Spondylolisthesis

  • Chapter
  • First Online:
Spondylolisthesis

  • 365 Accesses

Abstract

Spondylolisthesis has a complex and variable pathophysiology which has been a topic of research for many years. The complexity of the disorder and recommended treatments require an effective classification system which is easily remembered and applied. Classification systems have gone through many iterations starting with the Meyerding system and evolving into the SDSG (Spinal Deformity Study Group) system which is complex in its formulation but simple in application. However, several of the systems are still used commonly and may define treatment strategies. Therefore, familiarity with these various systems is required for every spine surgeon. This chapter reviews the various classification systems for spondylolisthesis and the application of the SDSG system in detail.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Meyerding HW. Spondylolisthesis. Surg Gynecol Obstet. 1932;54:371–7.

    Google Scholar 

  2. Radcliff K, Hwang R, Hilibrand A, Smith HE, Gruskay J, Lurie JD, et al. The effect of iliac crest autograft on the outcome of fusion in the setting of degenerative spondylolisthesis: a subgroup analysis of the spine patient outcomes research trial (SPORT). J Bone Jt Surg Am. 2012;94(18):1685–92.

    Article  Google Scholar 

  3. Rihn JA, Radcliff K, Hilibrand AS, Anderson DT, Zhao W, Lurie J, et al. Does obesity affect outcomes of treatment for lumbar stenosis and degenerative spondylolisthesis? Analysis of the spine patient outcomes research trial (SPORT). Spine (Phila Pa 1976). 2012;37(23):1933–46.

    Article  PubMed  Google Scholar 

  4. Smorgick Y, Park DK, Baker KC, Lurie JD, Tosteson TD, Zhao W, et al. Single versus multilevel fusion for single-level degenerative spondylolisthesis and multilevel lumbar stenosis: 4-year results of the spine patient outcomes research trial. Spine (Phila Pa 1976). 2013;38(10):797–805.

    Article  PubMed  Google Scholar 

  5. Riouallon G, Lachaniette CH, Poignard A, Allain J. Outcomes of anterior lumbar interbody fusion in low-grade isthmic spondylolisthesis in adults: a continuous series of 65 cases with an average follow-up of 6.6 years. Orthop Traumatol Surg Res. 2013;99(2):155–61.

    Article  CAS  PubMed  Google Scholar 

  6. Marchi L, Abdala N, Oliveira L, Amaral R, Coutinho E, Pimenta L. Stand-alone lateral interbody fusion for the treatment of low-grade degenerative spondylolisthesis. Sci World J. 2012;2012:456346.

    Article  Google Scholar 

  7. Farrokhi MR, Rahmanian A, Masoudi MS. Posterolateral versus posterior interbody fusion in isthmic spondylolisthesis. J Neurotrauma. 2012;29(8):1567–73.

    Article  PubMed  Google Scholar 

  8. Yuan JD, Wang J, Zhou HB, Fu Q, Chen ZM, Zhao J. Analysis of results on minimum 4-year follow-up of modified posterior lumbar interbody fusion for the treatment of isthmic spondylolisthesis. Zhongguo Gu Shang. 2010;23(7):519–22.

    PubMed  Google Scholar 

  9. Pearson AM, Lurie JD, Blood EA, Frymoyer JW, Braeutigam H, An H, et al. Spine patient outcomes research trial: radiographic predictors of clinical outcomes after operative or nonoperative treatment of degenerative spondylolisthesis. Spine (Phila Pa 1976). 2008;33(25):2759–66.

    Article  PubMed  Google Scholar 

  10. Weinstein JN, Lurie JD, Tosteson TD, Hanscom B, Tosteson AN, Blood EA, et al. Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis. N Engl J Med. 2007;356(22):2257–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Swan J, Hurwitz E, Malek F, van den Haak E, Cheng I, Alamin T, et al. Surgical treatment for unstable low-grade isthmic spondylolisthesis in adults: a prospective controlled study of posterior instrumented fusion compared with combined anterior–posterior fusion. Spine J. 2006;6(6):606–14.

    Article  PubMed  Google Scholar 

  12. Ekman P, Moller H, Hedlund R. The long-term effect of posterolateral fusion in adult isthmic spondylolisthesis: a randomized controlled study. Spine J. 2005;5(1):36–44.

    Article  PubMed  Google Scholar 

  13. Wiltse LL, Newman PH, Macnab I. Classification of spondylolisis and spondylolisthesis. Clin Orthop Relat Res. 1976;117:23–9.

    Google Scholar 

  14. Wynne-Davies R, Scott JH. Inheritance and spondylolisthesis: a radiographic family survey. J Bone Jt Surg Br. 1979;61-B(3):301–5.

    Article  CAS  Google Scholar 

  15. Frymoyer JW. Back pain and sciatica. N Engl J Med. 1988;318(5):291–300.

    Article  CAS  PubMed  Google Scholar 

  16. Petajan JH, Momberger GL, Aase J, Wright DG. Arthrogryposis syndrome (Kuskokwim disease) in the Eskimo. JAMA. 1969;209(10):1481–6.

    Article  CAS  PubMed  Google Scholar 

  17. Marchetti PG, Binazzi R, Briccoli A, Vaccari V, Borelli P, De Zerbi M, et al. The surgical treatment of spondylolisthesis. Chir Organ Mov. 1994;79(1):85–91.

    CAS  Google Scholar 

  18. Bridwell K, editor. Textbook of spinal surgery. Philadelphia: Lippincott-Raven; 1997.

    Google Scholar 

  19. Jackson DW, Wiltse LL, Cirincoine RJ. Spondylolysis in the female gymnast. Clin Orthop Relat Res. 1976;117:68–73.

    Google Scholar 

  20. Letts M, Smallman T, Afanasiev R, Gouw G. Fracture of the pars interarticularis in adolescent athletes: a clinical-biomechanical analysis. J Pediatr Orthop. 1986;6(1):40–6.

    Article  CAS  PubMed  Google Scholar 

  21. Mac-Thiong JM, Labelle H. A proposal for a surgical classification of pediatric lumbosacral spondylolisthesis based on current literature. Eur Spine J. 2006;15(10):1425–35.

    Article  PubMed  Google Scholar 

  22. Kasliwal MK, Smith JS, Kanter A, Chen CJ, Mummaneni PV, Hart RA, et al. Management of high-grade spondylolisthesis. Neurosurg Clin N Am. 2013;24(2):275–91.

    Article  PubMed  Google Scholar 

  23. Lamartina C, Zavatsky JM, Petruzzi M, Specchia N. Novel concepts in the evaluation and treatment of high-dysplastic spondylolisthesis. Eur Spine J. 2009;18(Suppl 1):133–42.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Herman MJ, Pizzutillo PD. Spondylolysis and spondylolisthesis in the child and adolescent: a new classification. Clin Orthop Relat Res. 2005;434:46–54.

    Article  Google Scholar 

  25. Haun DW, Kettner NW. Spondylolysis and spondylolisthesis: a narrative review of etiology, diagnosis, and conservative management. J Chiropr Med. 2005;4(4):206–17.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Dubousset J. Treatment of spondylolysis and spondylolisthesis in children and adolescents. Clin Orthop Relat Res. 1997;337:77–85.

    Article  Google Scholar 

  27. O’Brien MF, Kuklo TR, Blanke KM. Spinal deformity study group—radiographic measurement manual. Memphis: Medtronic Sofamor Danek; 2004.

    Google Scholar 

  28. Hanson DS, Bridwell KH, Rhee JM, Lenke LG. Correlation of pelvic incidence with low- and high-grade isthmic spondylolisthesis. Spine (Phila Pa 1976). 2002;27(18):2026–9.

    Article  PubMed  Google Scholar 

  29. Jackson RP, Phipps T, Hales C, Surber J. Pelvic lordosis and alignment in spondylolisthesis. Spine (Phila Pa 1976). 2003;28(2):151–60.

    Article  PubMed  Google Scholar 

  30. Labelle H, Roussouly P, Berthonnaud E, Transfeldt E, O’Brien M, Chopin D, et al. Spondylolisthesis, pelvic incidence, and spinopelvic balance: a correlation study. Spine (Phila Pa 1976). 2004;29(18):2049–54.

    Article  PubMed  Google Scholar 

  31. Roussouly P, Gollogly S, Berthonnaud E, Labelle H, Weidenbaum M. Sagittal alignment of the spine and pelvis in the presence of L5–S1 isthmic lysis and low-grade spondylolisthesis. Spine (Phila Pa 1976). 2006;31(21):2484–90.

    Article  PubMed  Google Scholar 

  32. Labelle H, Roussouly P, Transfeldt E, Hresko MT, O’Brien M, Berthonnaud E. The importance of spino-pelvic balance after spinal instrumentation for high grade developmental spondylolisthesis. In: Scoliosis Research Society annual meeting, September 10–13, Quebec City, Quebec, Canada; 2003.

    Google Scholar 

  33. Hresko MT, Labelle H, Roussouly P, editors. High grade spondylolisthesis: correlations between pelvic version and spine balance. In: Pediatric Orthopaedic Society of North America annual meeting, May 13–15, Ottawa, Ontario, Canada; 2005.

    Google Scholar 

  34. Askar Z, Wardlaw D, Koti M. Scott wiring for direct repair of lumbar spondylolysis. Spine (Phila Pa 1976). 2003;28(4):354–7.

    Article  PubMed  Google Scholar 

  35. Bradford DS, Iza J. Repair of the defect in spondylolysis or minimal degrees of spondylolisthesis by segmental wire fixation and bone grafting. Spine (Phila Pa 1976). 1985;10(7):673–9.

    Article  CAS  PubMed  Google Scholar 

  36. Grzegorzewski A, Kumar SJ. In situ posterolateral spine arthrodesis for grades III, IV, and V spondylolisthesis in children and adolescents. J Pediatr Orthop. 2000;20(4):506–11.

    Article  CAS  PubMed  Google Scholar 

  37. Lenke LG, Bridwell KH, Bullis D, Betz RR, Baldus C, Schoenecker PL. Results of in situ fusion for isthmic spondylolisthesis. J Spinal Disord. 1992;5(4):433–42.

    Article  CAS  PubMed  Google Scholar 

  38. Molinari RW, Bridwell KH, Lenke LG, Ungacta FF, Riew KD. Complications in the surgical treatment of pediatric high-grade, isthmic dysplastic spondylolisthesis. A comparison of three surgical approaches. Spine (Phila Pa 1976). 1999;24(16):1701–11.

    Article  CAS  PubMed  Google Scholar 

  39. Mardjetko S, Albert T, Andersson G, Bridwell K, DeWald C, Gaines R, et al. Spine/SRS spondylolisthesis summary statement. Spine (Phila Pa 1976). 2005;30(6 Suppl):S3.

    Article  PubMed  Google Scholar 

  40. Molinari RW, Bridwell KH, Lenke LG, Baldus C. Anterior column support in surgery for high-grade, isthmic spondylolisthesis. Clin Orthop Relat Res. 2002;394:109–20.

    Article  Google Scholar 

  41. Mac-Thiong JM, Labelle H, Parent S, Hresko MT, Deviren V, Weidenbaum M. Reliability and development of a new classification of lumbosacral spondylolisthesis. Scoliosis. 2008;3:19.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Hresko MT, Labelle H, Roussouly P, Berthonnaud E. Classification of high-grade spondylolistheses based on pelvic version and spine balance: possible rationale for reduction. Spine (Phila Pa 1976). 2007;32(20):2208–13.

    Article  PubMed  Google Scholar 

  43. Mac-Thiong JM, Duong L, Parent S, Hresko MT, Dimar JR, Weidenbaum M, et al. Reliability of the spinal deformity study group classification of lumbosacral spondylolisthesis. Spine (Phila Pa 1976). 2012;37(2):E95–102.

    Article  PubMed  Google Scholar 

  44. Bao H, Yan P, Zhu W, Bao M, Li Y, Zhang Z, et al. Validation and reliability analysis of the spinal deformity study group classification fort L5–S1 lumbar spondylolisthesis. Spine (Phila Pa 1976). 2015;40(21):E1150–4.

    Article  PubMed  Google Scholar 

  45. Simmonds AM, Rampersaud YR, Dvorak MF, Dea N, Melnyk AD, Fisher CG. Defining the inherent stability of degenerative spondylolisthesis: a systematic review. J Neurosurg Spine. 2015;23(2):178–89.

    Article  PubMed  Google Scholar 

  46. Li R, Wang Z, Ma L, Yang D, Xie D, Zhang B, et al. Lumbar vertebral endplate defects on magnetic resonance imaging in degenerative spondylolisthesis: novel classification, characteristics, and correlative factor analysis. World Neurosurg. 2020;141:e423–30.

    Article  PubMed  Google Scholar 

  47. Ghailane S, Bouloussa H, Challier V, Vergari C, Yoshida G, Obeid I, et al. Radiographic classification for degenerative spondylolisthesis of the lumbar spine based on sagittal balance: a reliability study. Spine Deform. 2018;6(4):358–65.

    Article  PubMed  Google Scholar 

  48. Kepler CK, Hilibrand AS, Sayadipour A, Koerner JD, Rihn JA, Radcliff KE, et al. Clinical and radiographic degenerative spondylolisthesis (CARDS) classification. Spine J. 2015;15(8):1804–11.

    Article  PubMed  Google Scholar 

  49. Sobol GL, Hilibrand A, Davis A, Millhouse P, Koerner J, Kepler C, et al. Reliability and clinical utility of the CARDS classification for degenerative spondylolisthesis. Clin Spine Surg. 2018;31(1):E69–73.

    Article  PubMed  Google Scholar 

  50. Sun Z, Xu C, Yin M, Yan W. Comparison of SDSG and CARDS classifications for L5/S1 lumbar degenerative spondylolisthesis: an independent inter- and intra-observer agreement study. J Orthop Surg Res. 2021;16(1):384.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Gille O, Bouloussa H, Mazas S, Vergari C, Challier V, Vital JM, et al. A new classification system for degenerative spondylolisthesis of the lumbar spine. Eur Spine J. 2017;26(12):3096–105.

    Article  PubMed  Google Scholar 

  52. Kong C, Sun X, Ding J, Guo M, Li X, Lu S. Comparison of the French and CARDS classifications for lumbar degenerative spondylolisthesis: reliability and validity. BMC Musculoskelet Disord. 2019;20(1):382.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Lin T, Zhang Z, Jiang Q, Yin J, Ma X, Wang C, Zhou X. The Joe-Lin operative classification system for pediatric lumbosacrtal spondylolysis and spondylolisthesis. World Neurosurg. 2020;142:e18–31.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Shriners Children’s - Philadelphia, Philadelphia, PA, USA

    Michael J. Yang & Amer F. Samdani

  2. Community Hospital Anderson, Anderson, IN, USA

    Richard Kim

  3. University of Virginia Health System, Charlottesville, VA, USA

    Anuj Singla

Authors
  1. Michael J. Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Richard Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anuj Singla
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Amer F. Samdani
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Stryker Spine, Brookfield, CT, USA

    Adam L. Wollowick

  2. Department of Orthopedic Surgery, Northwell Health, New Hyde Park, NY, USA

    Vishal Sarwahi

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Yang, M.J., Kim, R., Singla, A., Samdani, A.F. (2023). Classification of Spondylolisthesis. In: Wollowick, A.L., Sarwahi, V. (eds) Spondylolisthesis. Springer, Cham. https://doi.org/10.1007/978-3-031-27253-0_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-27253-0_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-27252-3

  • Online ISBN: 978-3-031-27253-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation