title: Symptomatic spondylolisthesis in adults: four decades later.
abstract: An average follow-up of 40 years was obtained for 12 patients with spondylolisthesis treated at Hines Veterans Administration Hospital between 1944 and 1951. In each case, the slip had been Grade 1 and at the L5-S1 level. Five had been treated conservatively and seven surgically with a Hibbs fusion from L4 to S1. Of the conservatively managed patients, all functioned well during their working years, although one did have chronic, nondisabling, low-back pain. This same patient demonstrated radiographic evidence of progression to a Grade 2 spondylolisthesis. Among those undergoing surgery, the poor results were confined to those patients whose fusion attempts failed. Management for low-grade spondylolisthesis should be conservative where possible. When the low-back pain is disabling and surgery becomes necessary, failure to obtain a fusion portends a poor clinical result.
authors.affiliation: Department of Orthopaedics and Rehabilitation, Loyola University Medical Center, Maywood, Illinois.
authors.forename: D M
authors.initials: DM
authors.lastname: Apel
authors.forename: M A
authors.initials: MA
authors.lastname: Lorenz
authors.forename: M R
authors.initials: MR
authors.lastname: Zindrick
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D013168:Spondylolisthesis / Q000628:therapy*