Lumbar stenosis with spondylolisthesis: current concepts of surgical treatment.
As degenerative changes progress in the aging population, more patients will present with degenerative spondylolisthesis. The clinical picture is usually of a woman older than 50 years of age with a degenerative lumbar spondylolisthesis at L5 with symptoms of neurogenic claudication or radiculopathy. Imaging studies will reveal a central recess, a lateral recess or both, and/or neuroforaminal stenosis. When patients do not respond to nonoperative treatments, surgical intervention is indicated. Most studies have concluded that the addition of an arthrodesis improves the clinical outcome. A recent longterm study showed that a solid fusion and an adequate decompression is the procedure offering the best outcome. The current authors will review the pathogenesis, clinical picture, and treatment recommendations for degenerative lumbar spondylolisthesis.
Department of Orthopedic Surgery, William Beaumont Hospital, Royal Oak, MI 48073, USA.
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Bassewitz
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Herkowitz
D000368:Aged; D019299:Decompression, Surgical; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016268:Internal Fixators; D008159:Lumbar Vertebrae / Q000601:surgery*; D008875:Middle Aged; D013123:Spinal Fusion; D013130:Spinal Stenosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D013168:Spondylolisthesis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*