[Spondylolisthesis in the growing spine].

Area of Science:

• Pediatric Orthopedics
• Spinal Surgery
• Developmental Disorders

Background:

• Spondylolisthesis, or vertebral slippage, in children often stems from defects (lysis) or elongation of the interarticular portion.
• Congenital dysplasia of dorsal stabilizing structures or facet pressure due to lumbar lordosis can cause this condition.

Purpose of the Study:

• To outline the treatment strategies for pediatric spondylolisthesis.
• To correlate treatment decisions with symptom severity, progression risk, and classification systems.

Main Methods:

• Treatment selection based on symptoms, sliding distance, secondary vertebral dysplasia, and sagittal profile.
• Utilizing the Mac-Thiong classification for assessing progression risk.
• Considering conservative therapy, pars repair, or spondylodesis based on olisthesis grade and disc status.

Main Results:

• Conservative therapy is suitable for low-grade spondylolisthesis.
• Pars repair is indicated for symptomatic lysis without disc degeneration.
• Higher-grade olistheses typically require repositioning and spondylodesis, balancing fusion rates against nerve root damage risk.

Conclusions:

• Treatment for pediatric spondylolisthesis must be individualized, considering the Mac-Thiong classification and risk of progression.
• Surgical interventions like pars repair or spondylodesis offer solutions for symptomatic or high-grade cases, with careful consideration of potential complications.