Degenerative cervical spondylolisthesis: a systematic review.
OBJECTIVE
Degenerative cervical spondylolisthesis has received insufficient attention, in contrast to degenerative lumbar spondylolisthesis. In fact, degenerative cervical spondylolisthesis may be more common than previously thought.


METHODS
In order to provide appropriate guidelines for the treatment of degenerative cervical spondylolisthesis, a systematic review of degenerative cervical spondylolisthesis was performed. An English literature search from January 1947 to November 2010 was completed with reference to radiological examination and management of degenerative cervical spondylolisthesis.


RESULTS
Of 102 patients with degenerative cervical spondylolisthesis, 52 patients (51%) had neck or occipital pain, 23 patients (22.5%) were referred with radiculopathy and 65 patients (63.7%) presented with myelopathy or myeloradiculopathy. Degenerative cervical spondylolisthesis was most common in C3/4 and C4/5, occurring in 81 patients at C3/4 (46%) and 87 at C4/5 (49.4%). Disc degeneration and facet hypertrophy were the main causes of this clinical entity. Of 123 patients, 57 (46.3%) were found to have segmental instability as shown by flexion-extension lateral radiographs. There are two classification systems for degenerative cervical spondylolisthesis. Surgery was indicated in patients who had radiologically proven cervical spondylolisthesis with instability and/or spinal cord compression.


CONCLUSIONS
Prospective studies should be designed in the future to draw a more reliable conclusion about the management of degenerative cervical spondylolisthesis.
Department of Orthopedic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, 200092 Shanghai, China.
Sheng-Dan
SD
Jiang
Lei-Sheng
LS
Jiang
Li-Yang
LY
Dai
D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000473:pathology / Q000601:surgery; D008297:Male; D011859:Radiography; D013168:Spondylolisthesis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*
Spine J. 2009 Jun;9(6):439-46
19111509
Spine (Phila Pa 1976). 2003 Jun 1;28(11):1128-34
12782980
J Neurol Neurosurg Psychiatry. 1984 Jan;47(1):17-20
6693912
Skeletal Radiol. 1986;15(6):439-43
3764470
J Bone Joint Surg Br. 1976 May;58(2):184-92
932080
J Orthop Sci. 2007 May;12(3):207-13
17530371
Eur Spine J. 2006 Mar;15(3):257-69
16235100
Eur Spine J. 2004 Dec;13(8):680-4
15221569
Radiol Clin North Am. 1977 Aug;15(2):275-87
887740
J Bone Joint Surg Br. 1995 Jan;77(1):122-5
7822368
J Rheumatol. 1987 Aug;14(4):780-3
3668984
Eur Spine J. 2010 May;19(5):720-5
20191294
J Neurosurg. 1970 Apr;32(4):421-6
5417937
Spine (Phila Pa 1976). 1988 Jun;13(6):618-25
3175751
Brain. 1971;94(3):587-94
5111719
J Bone Joint Surg Am. 1951 Oct;33-A(4):1012-3
14880558
Clin Orthop Relat Res. 1975;(109):85-96
1132209
Neurology. 1962 Aug;12:513-9
14485123
J Spinal Disord. 1996 Jun;9(3):241-5
8854280
Instr Course Lect. 1995;44:99-110
7797896