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Spondylolisthesis
Kevin R. Moore, MD; Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Degenerative spondylolisthesis (DS)
            • Definitions

              • Displacement of vertebral body, described relative to inferior vertebra
                • Anterolisthesis: Anterior displacement of vertebral body relative to 1 below
                • Retrolisthesis: Posterior displacement of vertebral body relative to 1 below
                • Spondyloptosis: Vertebral body displaced completely anteriorly with inferior displacement to level of 1 below
              • DS describes anterior slippage of vertebral body on another in presence of intact neural arch

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Beck AW et al: High-grade lumbar spondylolisthesis. Neurosurg Clin N Am. 30(3):291-8, 2019
                                          2. Chan AK et al: Summary of guidelines for the treatment of lumbar spondylolisthesis. Neurosurg Clin N Am. 30(3):353-64, 2019
                                          3. Noorian S et al: A systematic review of clinical outcomes in surgical treatment of adult isthmic spondylolisthesis. Spine J. 18(8):1441-54, 2018
                                          4. Matz PG et al: Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spondylolisthesis. Spine J. 16(3):439-48, 2016
                                          5. Smorgick Y et al: Single-versus multilevel fusion for single-level degenerative spondylolisthesis and multilevel lumbar stenosis: four-year results of the spine patient outcomes research trial. Spine (Phila Pa 1976). 38(10):797-805, 2013
                                          6. Lattig F et al: Lumbar facet joint effusion in MRI: a sign of instability in degenerative spondylolisthesis? Eur Spine J. 21(2):276-81, 2012
                                          7. Sansur CA et al: Morbidity and mortality in the surgical treatment of 10,242 adults with spondylolisthesis. J Neurosurg Spine. 13(5):589-93, 2010
                                          8. Ekman P et al: Predictive factors for the outcome of fusion in adult isthmic spondylolisthesis. Spine (Phila Pa 1976). 34(11):1204-10, 2009
                                          9. Watters WC 3rd et al: An evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spondylolisthesis. Spine J. 9(7):609-14, 2009
                                          10. Weinstein JN et al: 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(6):1295-304, 2009
                                          11. DiPaola CP et al: Posterior lumbar interbody fusion. J Am Acad Orthop Surg. 16(3):130-9, 2008
                                          12. Don AS et al: Facet joint orientation in spondylolysis and isthmic spondylolisthesis. J Spinal Disord Tech. 21(2):112-5, 2008
                                          13. Kalichman L et al: Diagnosis and conservative management of degenerative lumbar spondylolisthesis. Eur Spine J. 17(3):327-35, 2008
                                          14. Majid K et al: Degenerative lumbar spondylolisthesis: trends in management. J Am Acad Orthop Surg. 16(4):208-15, 2008
                                          15. Park P et al: Minimally invasive transforaminal lumbar interbody fusion with reduction of spondylolisthesis: technique and outcomes after a minimum of 2 years' follow-up. Neurosurg Focus. 25(2):E16, 2008
                                          16. Martin CR et al: The surgical management of degenerative lumbar spondylolisthesis: a systematic review. Spine (Phila Pa 1976). 32(16):1791-8, 2007
                                          17. Weinstein JN et al: Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis. N Engl J Med. 356(22):2257-70, 2007
                                          18. Lamm M et al: Acute traumatic L5-S1 spondylolisthesis. J Spinal Disord Tech. 16(6):524-7, 2003
                                          19. Pneumaticos SG et al: Scoliosis associated with lumbar spondylolisthesis: a case presentation and review of the literature. Spine J. 3(4):321-4, 2003
                                          20. Bassewitz H et al: Lumbar stenosis with spondylolisthesis: current concepts of surgical treatment. Clin Orthop. (384):54-60, 2001
                                          21. Nizard RS et al: Radiologic assessment of lumbar intervertebral instability and degenerative spondylolisthesis. Radiol Clin North Am. 39(1):55-71, v-vi, 2001
                                          22. Cinotti G et al: Predisposing factors in degenerative spondylolisthesis. A radiographic and CT study. Int Orthop. 21(5):337-42, 1997
                                          23. Herkowitz HN: Spine update. Degenerative lumbar spondylolisthesis. Spine. 20(9):1084-90, 1995
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Synonyms

                                                      • Degenerative spondylolisthesis (DS)
                                                    • Definitions

                                                      • Displacement of vertebral body, described relative to inferior vertebra
                                                        • Anterolisthesis: Anterior displacement of vertebral body relative to 1 below
                                                        • Retrolisthesis: Posterior displacement of vertebral body relative to 1 below
                                                        • Spondyloptosis: Vertebral body displaced completely anteriorly with inferior displacement to level of 1 below
                                                      • DS describes anterior slippage of vertebral body on another in presence of intact neural arch

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • CT Findings

                                                          • MR Findings

                                                            • Nuclear Medicine Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Staging, Grading, & Classification

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Beck AW et al: High-grade lumbar spondylolisthesis. Neurosurg Clin N Am. 30(3):291-8, 2019
                                                                                  2. Chan AK et al: Summary of guidelines for the treatment of lumbar spondylolisthesis. Neurosurg Clin N Am. 30(3):353-64, 2019
                                                                                  3. Noorian S et al: A systematic review of clinical outcomes in surgical treatment of adult isthmic spondylolisthesis. Spine J. 18(8):1441-54, 2018
                                                                                  4. Matz PG et al: Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spondylolisthesis. Spine J. 16(3):439-48, 2016
                                                                                  5. Smorgick Y et al: Single-versus multilevel fusion for single-level degenerative spondylolisthesis and multilevel lumbar stenosis: four-year results of the spine patient outcomes research trial. Spine (Phila Pa 1976). 38(10):797-805, 2013
                                                                                  6. Lattig F et al: Lumbar facet joint effusion in MRI: a sign of instability in degenerative spondylolisthesis? Eur Spine J. 21(2):276-81, 2012
                                                                                  7. Sansur CA et al: Morbidity and mortality in the surgical treatment of 10,242 adults with spondylolisthesis. J Neurosurg Spine. 13(5):589-93, 2010
                                                                                  8. Ekman P et al: Predictive factors for the outcome of fusion in adult isthmic spondylolisthesis. Spine (Phila Pa 1976). 34(11):1204-10, 2009
                                                                                  9. Watters WC 3rd et al: An evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spondylolisthesis. Spine J. 9(7):609-14, 2009
                                                                                  10. Weinstein JN et al: 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(6):1295-304, 2009
                                                                                  11. DiPaola CP et al: Posterior lumbar interbody fusion. J Am Acad Orthop Surg. 16(3):130-9, 2008
                                                                                  12. Don AS et al: Facet joint orientation in spondylolysis and isthmic spondylolisthesis. J Spinal Disord Tech. 21(2):112-5, 2008
                                                                                  13. Kalichman L et al: Diagnosis and conservative management of degenerative lumbar spondylolisthesis. Eur Spine J. 17(3):327-35, 2008
                                                                                  14. Majid K et al: Degenerative lumbar spondylolisthesis: trends in management. J Am Acad Orthop Surg. 16(4):208-15, 2008
                                                                                  15. Park P et al: Minimally invasive transforaminal lumbar interbody fusion with reduction of spondylolisthesis: technique and outcomes after a minimum of 2 years' follow-up. Neurosurg Focus. 25(2):E16, 2008
                                                                                  16. Martin CR et al: The surgical management of degenerative lumbar spondylolisthesis: a systematic review. Spine (Phila Pa 1976). 32(16):1791-8, 2007
                                                                                  17. Weinstein JN et al: Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis. N Engl J Med. 356(22):2257-70, 2007
                                                                                  18. Lamm M et al: Acute traumatic L5-S1 spondylolisthesis. J Spinal Disord Tech. 16(6):524-7, 2003
                                                                                  19. Pneumaticos SG et al: Scoliosis associated with lumbar spondylolisthesis: a case presentation and review of the literature. Spine J. 3(4):321-4, 2003
                                                                                  20. Bassewitz H et al: Lumbar stenosis with spondylolisthesis: current concepts of surgical treatment. Clin Orthop. (384):54-60, 2001
                                                                                  21. Nizard RS et al: Radiologic assessment of lumbar intervertebral instability and degenerative spondylolisthesis. Radiol Clin North Am. 39(1):55-71, v-vi, 2001
                                                                                  22. Cinotti G et al: Predisposing factors in degenerative spondylolisthesis. A radiographic and CT study. Int Orthop. 21(5):337-42, 1997
                                                                                  23. Herkowitz HN: Spine update. Degenerative lumbar spondylolisthesis. Spine. 20(9):1084-90, 1995