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Degenerative spondylolisthesis.

M J Bolesta, H H Bohlman

    Instructional Course Lectures
    |January 1, 1989
    PubMed
    Summary
    This summary is machine-generated.

    Degenerative spondylolisthesis involves facet joint arthritis and instability, often affecting the lower spine. Surgical decompression and posterolateral fusion are recommended for significant nerve compression and to prevent progression.

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    Area of Science:

    • Orthopedics
    • Neurosurgery
    • Spinal Surgery

    Background:

    • Degenerative spondylolisthesis is a spinal condition characterized by facet joint arthritis and segmental instability.
    • It frequently involves the L4-L5 level and is associated with varying degrees of disc degeneration.
    • This condition is more prevalent in females and Black individuals over 40.

    Purpose of the Study:

    • To describe the characteristics of degenerative spondylolisthesis.
    • To outline the common symptoms and neurological compromise.
    • To recommend appropriate surgical management strategies.

    Main Methods:

    • The study describes the clinical and radiological features of degenerative spondylolisthesis.
    • It reviews patient demographics, common levels of involvement, and associated pathologies.

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  • Diagnostic findings and treatment outcomes are discussed.

    • Main Results:

    • The L4-L5 level is most commonly affected, often with associated lateral stenosis compressing nerve roots.
    • Symptoms include neurogenic claudication and radiculopathy; neurologic deficits are present in less than half of patients.
    • Cauda equina syndrome is a rare initial presentation.

    Conclusions:

    • Degenerative spondylolisthesis requires surgical intervention for significant neurologic symptoms, primarily decompression.
    • Posterolateral fusion is recommended due to the potential for postoperative progression of the deformity.
    • Early diagnosis and appropriate surgical technique are crucial for managing this condition.