title: The natural history of degenerative spondylolisthesis of the cervical spine with 2- to 7-year follow-up.
abstract: METHODS
  Retrospective study.
  
  
  OBJECTIVE
  To determine whether cervical degenerative spondylolisthesis is unstable and/or progresses.
  
  
  BACKGROUND
  Cervical degenerative spondylolisthesis is relatively common in the elderly. However, there are no reports regarding its natural history.
  
  
  METHODS
  We identified 27 patients with cervical degenerative spondylolisthesis (3.9%) from a database of 697 patients, using cervical radiographs. All had neutral and dynamic lateral radiographs at baseline and at a minimum of 24 months later (mean 39 mo, range, 24-92 mo). The mean age of the patients at the initial visit was 59.0 years (range, 50-83 yr). Male to female ratio was 16:11. Radiographical findings and clinical symptoms related to spondylolisthesis were assessed at initial and final follow-up.
  
  
  RESULTS
  Eleven patients had cervical spondylolisthesis at C4-C5, 9 at C3-C4, 6 at C5-C6, and 1 at C2-C3. Initially, 6 had anterolisthesis and 21 had retrolisthesis. At baseline, 3 of 6 patients with anterolisthesis and 7 of 21 patients with retrolisthesis had translation of more than 2 mm on dynamic views. At baseline, 11 had no cervical symptoms, 8 had cervicalgia, 7 had radiculopathy, and 1 had myelopathy. At the final visit, none of the anterolistheses or retrolistheses had progressed. At the final visit, 7 of 10 patients with initial translation of more than 2 mm on dynamic views had no change. Of 17 patients with less than 2 mm of initial dynamic motion, 3 patients progressed to have more than 2 mm of dynamic translation. All 3 of these had retrolisthesis initially. None had clinical worsening of symptoms at the final visit.
  
  
  CONCLUSIONS
  The natural history of cervical degenerative anterolisthesis and retrolisthesis seems to be stable during 2 years to nearly 8 years. Although those with retrolisthesis seem to have a higher propensity to increase their subluxation, none experienced dislocation or neurological injury.
  
  
  METHODS
  4.
authors.affiliation: Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University, Pyeongchon-dong, Dongan-gu, Anyang-si, Gyeonggi-do, Republic of Korea. amhangpark@yahoo.co.kr
authors.forename: Moon Soo
authors.initials: MS
authors.lastname: Park
authors.forename: Seong-Hwan
authors.initials: SH
authors.lastname: Moon
authors.forename: Hwan-Mo
authors.initials: HM
authors.lastname: Lee
authors.forename: Seok Woo
authors.initials: SW
authors.lastname: Kim
authors.forename: Tae-Hwan
authors.initials: TH
authors.lastname: Kim
authors.forename: Bo-Kyung
authors.initials: BK
authors.lastname: Suh
authors.forename: K Daniel
authors.initials: KD
authors.lastname: Riew
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging* / Q000503:physiopathology; D007593:Joint Instability / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D013168:Spondylolisthesis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013997:Time Factors