Degenerative Spondylolisthesis: A Narrative Review

Area of Science:

• Orthopedics
• Neurosurgery
• Spinal Surgery

Background:

• Degenerative spondylolisthesis (DS) is characterized by vertebral slippage due to degenerative changes, leading to spinal stenosis and neurogenic claudication.
• Prevalence varies with age and gender, with risk factors including occupational driving, manual labor, and sedentary work.
• Diagnosis relies on clinical evaluation and imaging, including standing radiographs and MRI.

Purpose of the Study:

• To review the current understanding and management strategies for degenerative spondylolisthesis.
• To highlight the controversies in surgical decision-making, particularly regarding fusion with decompression.
• To emphasize the potential benefits of spinal minimally invasive surgery for DS.

Main Methods:

• Review of existing literature on degenerative spondylolisthesis.
• Analysis of diagnostic approaches, including clinical assessment and imaging modalities.
• Evaluation of treatment outcomes for conservative and surgical interventions.

Main Results:

• Conservative treatment is often effective for symptomatic DS without neurological deficits.
• Surgical intervention is indicated for patients with neurological symptoms and progressive deterioration.
• There is ongoing debate regarding the addition of fusion to decompression and the optimal fusion technique.

Conclusions:

• Spinal minimally invasive surgery presents a promising option for DS management, associated with reduced morbidity and improved patient outcomes.
• Further research is needed to resolve controversies surrounding surgical techniques and fusion in DS.
• Minimally invasive approaches enhance recovery, reduce pain, and improve quality of life for DS patients.