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J Am Acad Orthop Surg, Vol 16, No 4, April 2008, 208-215.
© 2008 the American Academy of Orthopaedic Surgeons
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Degenerative Lumbar Spondylolisthesis: Trends in Management

Kamran Majid, MD and Jeffrey S. Fischgrund, MD

Dr. Majid is Spine Fellow, William Beaumont Hospital, Royal Oak, MI. Dr. Fischgrund is Spine Fellowship Director, William Beaumont Hospital.

Neither Dr. Majid nor a member of his immediate family has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article. Dr. Fischgrund or a member of his immediate family serves as a consultant to or is an employee of Stryker.

Reprint requests: Dr. Fischgrund, Suite 200B, 27207 Lahser Road, Southfield, MI 48034-8471.

Degenerative spondylolisthesis with spinal stenosis is common in elderly patients. When symptomatic, the resultant neurogenic claudication often leads to a diminished quality of life. A nonsurgical approach is an appropriate first step. Maximizing the chance of a solid arthrodesis improves the possibility of a successful long-term outcome. Treatment of this pathology has evolved over the past twenty years with the publication of numerous prospective randomized trials assessing the influence of fusion and instrumentation following decompression. Current prospective trials have evaluated the use of bone morphogenetic proteins as a substitute for autogenous bone graft. Recently, soft-tissue stabilization devices have been advocated as an alternative to fusion. Clinicians should critically evaluate these newer technologies and exercise caution regarding their use until controlled long-term trials are completed. 






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Copyright © 2008 by the American Academy of Orthopaedic Surgeons.