Diagnosis and conservative management of degenerative lumbar spondylolisthesis.

Abstract

Degenerative spondylolisthesis (DS) is a disorder that causes the slip of one vertebral body over the one below due to degenerative changes in the spine. Lumbar DS is a major cause of spinal canal stenosis and is often related to low back and leg pain. We reviewed the symptoms, prognosis and conservative treatments for symptoms associated with DS. PubMed and MEDLINE databases (1950-2007) were searched for the key words "spondylolisthesis", "pseudospondylolisthesis", "degenerative spondylolisthesis", "spinal stenosis", "lumbar spine", "antherolisthesis", "posterolisthesis", "low back pain", and "lumbar instability". All relevant articles in English were reviewed. Pertinent secondary references were also retrieved. The prognosis of patients with DS is favorable, however, those who suffer from neurological symptoms such as intermittent claudication or vesicorectal disorder, will most probably experience neurological deterioration if they are not operated upon. Nonoperative treatment should be the initial course of action in most cases of DS, with or without neurologic symptoms. Treatment options include use of analgesics and NSAIDs to control pain; epidural steroid injections, and physical methods such as bracing and flexion strengthening exercises. An up-to-date knowledge on diagnosis and prevention of lumbar DS can assist in determination of future research goals. Additional studies are required to establish treatment protocols for the conservative treatment of DS.

• Authors: Leonid Kalichman, David J Hunter
• Journal: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (Eur Spine J) Vol. 17 Issue 3 Pg. 327-335 (Mar 2008) ISSN: 1432-0932 [Electronic] Germany
• PMID: 18026865 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Analgesics
• Anti-Inflammatory Agents

Topics

• Analgesics (therapeutic use)
• Anti-Inflammatory Agents (therapeutic use)
• Diagnosis, Differential
• Diagnostic Imaging (methods, standards)
• Exercise Therapy (methods, standards)
• Humans
• Low Back Pain (diagnosis, etiology, therapy)
• Lumbar Vertebrae (drug effects, pathology, physiopathology)
• Spondylolisthesis (diagnosis, physiopathology, therapy)