Lumbar spondylolisthesis: common, but surgery is rarely needed

Research output: Contribution to journalArticleAcademic

Abstract

Lumbar spondylolisthesis is usually asymptomatic. However, symptomatic spondylolisthesis results in back and/or leg pain such as radicular syndrome or neurogenic claudication. Variation in symptoms is caused by different types of spondylolisthesis. Lytic spondylolisthesis, most common at L5S1, is caused by spondylolysis of the pars interarticularis. This results in foraminal nerve compression and radicular symptoms. Degenerative spondylolisthesis, most common at L4L5 in patients >50 years old, is caused by slippage of the vertebral body and lamina, resulting in lumbar spinal stenosis and neurogenic claudication. Iatrogenic spondylolisthesis develops in 1.6-32.0% of patients after decompression surgery, causing recurrent neurogenic symptoms. It is important to understand the main symptoms patients experience: back or leg pain. In both cases, the preferred treatment is conservative. Surgery is only an option if patients have persistent/progressive leg pain. Shared decision-making is necessary to select the most accurate surgery for each individual patient while also taking into account age, comorbidities and symptoms. Further research is necessary to determine the advantages of each surgery in order to improve advice to patients.

Translated title of the contributionLumbar spondylolisthesis: common, but surgery is rarely needed
Original languageDutch
Article numberD3769
JournalNederlands Tijdschrift voor Geneeskunde
Volume163
Publication statusPublished - 24 Sep 2019

Keywords

  • Aged
  • Back Pain/etiology
  • Decompression, Surgical/adverse effects
  • Female
  • Humans
  • Intermittent Claudication/etiology
  • Lumbar Vertebrae/pathology
  • Male
  • Middle Aged
  • Radiculopathy/etiology
  • Spinal Stenosis/etiology
  • Spondylolisthesis/complications

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