Bone Health

J Bone Joint Surg Br. 1980 May;62-B(2):155-7. Scoliosis in symptomatic spondylolisthesis.McPhee IB, O'Brien JP. The association between spondylolisthesis and scoliosis was studied in 84 patients who presented during a 30-year period with symptomatic spondylolisthesis. The incidence of scoliosis was 42 per cent, the majority of cases being lumbar or thoracolumbar curves of less than 15 degrees. The incidence was highest in the group of patients with spondylolisthesis at L4--5 where all except one had scoliosis. Scoliosis was present in 47 per cent of patients with dysplastic spondylolisthesis at the lumbosacral junction; in this group, the incidence of scoliosis was greater where the displacement exceeded 25 per cent. The lowest incidence (25 per cent) was found in the group with isthmic spondylolisthesis at the lumbosacral junction. There appeared to be no relationship between excessive lumbar lordosis or tightness of the hamstrings and scoliosis.

Spondylolisthesis
K.- P. Schulitz Internet Journal of Orthopaedic Surgery and Related Subjects Issue 2-3 1997 Orthopaedic Department of Heinrich-Heine-University Düsseldorf, Germany
The current pathways of treatment for spondylolisthesis are presented and discussed on the background of our own experience and the available literature. Special consideration is given to the necessity of a reduction.

J Orthop Surg (Hong Kong). 2003 Dec;11(2):202-6. Degenerative spondylolisthesis at the L4-L5 in a 32-year-old female with previous fusion for idiopathic scoliosis: a case report.Winter RB, Silverman BJ. University of Minnesota, Minneapolis, MN, USA. We report a case of degenerative L4-L5 spondylolisthesis in a 32-year-old female who had undergone thoracic (lower level T12) fusion as a teenager. All other levels in the lumbar spine were normal on magnetic resonance imaging. Subsequent fusion of L4-L5 led to improvement in function and alleviation of pain for more than 4 years. The possible relationship between the previous fusion and degenerative spondylolisthesis is discussed.

Bilateral Decompressive Surgery in Lumbar Spinal Stenosis Associated With Spondylolisthesis: Unilateral Approach and Use of a Microscope and Tubular Retractor System
from Neurosurgical Focus Posted 09/09/2002
Sylvain Palmer, M.D., Robert Turner, M.D., and Rosemary Palmer, R.N.
Abstract Object: The objective of this study was to assess the feasibility and efficacy of treating spondylolisthesis-related spinal stenosis via unilateral approach bilateral decompression in which METRx-MD instrumentation is placed.
Conclusions: By following the authors' procedure, minimally invasive bilateral decompression of acquired spinal stenosis associated with spondylolisthesis can be successfully performed on an outpatient basis, with reasonable operative times, minimal blood loss, and acceptable morbidity.

The Effectiveness Of Epidural Steroids In The Treatment Of Degenerative Spondylolisthesis

Steven M. Theiss, MD, Birmingham, Ala, from the Division of Orthopedic Surgery, University of Alabama at Birmingham. J South Orthop Assoc 10(3):164-172, 2001.
Abstract: Isthmic spondylolisthesis, or spondylolisthesis due to a lesion of the pars interarticularis, is a common source of pain and disability in both the pediatric and adult population. This review examines the current diagnostic and treatment options for patients with this condition. It also reviews the results of the various interventions to facilitate the surgeon in choosing the appropriate treatment option for any given patient.

Archive copy 2003

People with lumbar degenerative spondylolisthesis who are treated surgically experience substantially better pain relief and gain of function than those who are treated without surgery, according to a study published in the latest issue of The New England Journal of Medicine. May 30, 2007 (Insidermedicine)

Orthochina.org Case Presentation March 2006 Lumbar Kyphosis and Spondylolisthesis

Author: Beth B Froese, MD, Consulting Staff, Department of Physical Medicine and Rehabilitation, Orthopaedic Associates of DuPage Ltd
Synonyms and related keywords: spondylolysis, spondylolisthesis, spinal abnormality, spinal disfunction, SCI, spinal cord injury, low back pain, LBP, disk pain, disc pain, discogenic pain, diskogenic pain
Spondylolysis is a defect in the pars interarticularis that may or may not be accompanied by forward translation of one vertebra relative to another (spondylolisthesis). Wiltse, Macnab, and Newman developed a classification to help outline causes of vertebral translation in an anterior direction. Their categories include the following:

Type I: Congenital spondylolisthesis
Type II: Isthmic spondylolisthesis
Type III: Degenerative spondylolisthesis
Type IV: Traumatic spondylolisthesis
Type V: Pathologic spondylolisthesis

Synonyms and related keywords: lumbosacral spondylolisthesis, isthmic spondylolisthesis, spondylolysis, hyperextension of the lumbar spine, lumbar spine hyperextension, hyperextended back, hyperextended spine, back pain, lower back pain, low back pain, LBP, spondylolytic spondylolisthesis, lytic spondylolisthesis, pars interarticularis stress fracture, spine stress fracture
Author: Adam E Perrin, MD, FAAFP, Consulting Staff, Spine and Sports Center of Connecticut; Community Preceptor, Family Practice Residency Program, Middlesex Hospital
Coauthor(s): Brian J Shiple, DO, Chief, Director of Primary Care Sport, Department of Family Medicine, Division of Sports Medicine, Clinical Assistant Professor, Crozer-Keystone Health Systems
Spondylolisthesis is defined as forward translation of a vertebral body with respect to the vertebra below. The term is derived from the Greek roots spondylo, meaning spine, and listhesis, meaning to slide down a slippery path. Spondylolisthesis can occur at any level of the spinal column, although it is most common in the lower lumbar spine. Most cases are thought to result from minor overuse trauma, particularly repetitive hyperextension of the lumbar spine. Spondylolysis, a break in the vertebra typically in the region of the pars interarticularis, may or may not be associated with a spondylolisthesis. If the pars defect is bilateral, it may allow slippage of the vertebra, typically L5 on S1, resulting in spondylolisthesis.
Both spondylolysis and spondylolisthesis are often asymptomatic, and the degree of spondylolisthesis does not necessarily correlate with the incidence or severity of symptoms, even when a patient is experiencing back pain. However, these 2 entities have been reported to be the most common underlying causes of persistent low back pain among children and adolescents, despite the fact that most cases are asymptomatic.

S Seitsalo Orthopaedic Hospital of the Invalid Foundation, Helsinki, Finland.
We made a retrospective study of 149 children and adolescents with moderate spondylolisthesis (slip less than or equal to 30%), 77 treated by fusion and 72 conservatively at an average follow-up of 13.3 years.

Neurosurg Focus 7(6), 1999. Giovanni La Rosa, M.D., Antonino Germanò, M.D., Alfredo Conti, M.D., Fabio Cacciola, M.D., Gerardo Caruso, M.D., Francesco Tomasello, M.D., Neurosurgical Clinic, University of Messina School of Medicine, Messina, Italy
Surgery for adult patients with lumbar and lumbosacral spondylolisthesis is reserved for those with intractable radiculopathy, claudication, or symptomatic spinal instability. Internal fixation, in which posterior fusion, transpedicular screw fixation, and implantation of titanium devices are performed, has been advocated to improve fusion rates and clinical results. Fourteen consecutive patients with Grade II to III lumbar and lumbosacral spondylolisthesis who underwent posterior decompression, reduction, autologous posterior facet joint arthrodesis, and SOCON-SRI implantation are retrospectively reviewed.

Radiology case 338-776

Patient Information: There are various types of spondylolisthesis.
Spondylolisthesis - Isthmic The most common form of spondylolisthesis, caused by a defect or fracture in the pars interarticularis
Spondylolisthesis - Degenerative Result of wear and tear on the vertebrae, most commonly seen in patients over the age of 50
Spondylolisthesis - High Grade 50% or more of the vertebral body has slipped forward