The Spine Journal
Volume 10, Issue 6 , Pages 530-543, June 2010

Contemporary management of isthmic spondylolisthesis: pediatric and adult

  • Steven S. Agabegi, MD

      Affiliations

    • Department of Orthopaedic Surgery, University of Cincinnati, PO Box 670212, Cincinnati, OH 45267, USA
    • Corresponding Author InformationCorresponding author. Department of Orthopaedic Surgery, University of Cincinnati, PO Box 670212, Cincinnati, OH 45267, USA. Tel.: (610) 717-8597.
    • ,
  • Jeffrey S. Fischgrund, MD

      Affiliations

    • Ste. 200-B, 27207 Lahser Rd, Southfield, MI 48034-2168, USA

Received 2 February 2010; accepted 18 February 2010. published online 12 April 2010.

Abstract 

Background

Isthmic spondylolisthesis is common in pediatric and adult patients. Most cases are asymptomatic. When symptomatic, nonsurgical treatment is an appropriate first step. Surgical treatment of this condition varies depending on patient age, degree of slip, presence of neurologic findings, and degree of deformity.

Purpose

To review the literature on the management of isthmic spondylolisthesis in pediatric and adult patients.

Study Design

Review article.

Methods

Literature review.

Results and Conclusions

Achieving a solid fusion leads to improved functional outcomes and reduction in pain. A circumferential fusion is associated with a higher fusion rate and has become more common, especially with high-grade slips. The need for reduction is controversial and is mostly indicated for patients with significant lumbosacral kyphosis and sagittal imbalance.

Keywords: Isthmic spondylolisthesis, Spondylolysis, Pediatric, Adult

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 This Contemporary Concepts in Spine Care review is part of a series of referenced reviews of contemporary issues in spine care produced by the North American Spine Society (NASS). Each review represents the current state of knowledge on a particular topic. Prior to entering the review process for The Spine Journal, the authors were assisted by members of the NASS Committee on Contemporary Concepts: Darrel Brodke, MD, Chair; Christopher Bono, MD; Robert Dawe, MD; and Mitchell B. Harris, MD.

 FDA device/drug status: not applicable.

 Author disclosures: JSF (royalties, DePuy; consulting, Stryker, releavant, Apatech, Smith and Nephew; research support, Smith and Nephew).

PII: S1529-9430(10)00128-2

doi:10.1016/j.spinee.2010.02.023

The Spine Journal
Volume 10, Issue 6 , Pages 530-543, June 2010

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