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.
Bassewitz
H
H
Department of Orthopedic Surgery, William Beaumont Hospital, Royal Oak, MI 48073, USA.
Herkowitz
H
H
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*