Degenerative Spondylolisthesis: A Narrative Review

Degenerative Spondylolisthesis: A Narrative Review


  • Ibrahim Akkawi Villa Erbosa Hospital 50/2, 40129, Bologna, Italy
  • Hassan Zmerly Ludes Lugano Campus, Lugano, Switzerland


Degenerative spondylolisthesis; decompression ; fusion ; spinal stenosis ; pedicle screw


Degenerative spondylolisthesis (DS) is a condition leading to the slippage of one vertebral body over the one below due to degenerative changes resulting in spinal stenosis and producing neurogenic claudication, with or without low back pain. DS prevalence is age and gender specific. Other risk factors mainly include a history of occupational driving, intense manual activity and sedentary work. Diagnosis for patients with DS include detailed history, physical examination and imaging through standing lateral radiographs and MRI. Most patients with symptomatic DS and absence of neurologic deficits should perform better with conservative treatment, whereas, patients with neurological symptoms, are more prone to undergo progressive functional deterioration without surgery. There is a lack of agreement on the best surgical management in patients with DS and symptomatic stenosis. There is a contradictory data that does not permit for a recommendation for or against the addition of fusion to decompression. There is also controversy on which fusion technique is best. Spinal minimally invasive surgery is a promising approach for DS promoting early recovery and enhanced quality of life by reducing skin incision, muscular damage and perioperative pain with significant improvements in clinical results and high satisfaction rates.


1. Bydon M, Alvi MA, Goyal A. Degenerative Lumbar Spondylolisthesis: Definition, Natural History, Conservative Management, and Surgical Treatment. Neurosurg Clin N Am. 2019;30(3):299‐304
2. Koreckij TD, Fischgrund JS. Degenerative Spondylolisthesis. J Spinal Disord Tech. 2015;28(7):236‐241
3. Wang YXJ, Káplár Z, Deng M, Leung JCS. Lumbar degenerative spondylolisthesis epidemiology: A systematic review with a focus on gender-specific and age-specific prevalence. J Orthop Translat. 2016;11:39‐52.
4. Kobayashi H, Endo K, Sawaji Y, et al. Global sagittal spinal alignment in patients with degenerative low-grade lumbar spondylolisthesis. J Orthop Surg (Hong Kong). 2019;27(3):2309499019885190.
5. Kong C, Wang W, Li X, Sun X, Ding J, Lu S. A new lever reduction technique for the surgical treatment of elderly patients with lumbar degenerative Spondylolisthesis. BMC Musculoskelet Disord. 2020;21(1):11.
6. Weinstein JN, Lurie JD, Tosteson TD, et al. Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis. N Engl J Med. 2007;356(22):2257‐2270.
7. Ishimoto Y, Cooper C, Ntani G, et al. Is radiographic lumbar spondylolisthesis associated with occupational exposures? Findings from a nested case control study within the Wakayama spine study. BMC Musculoskelet Disord. 2019;20(1):618.
8. Aono K, Kobayashi T, Jimbo S, Atsuta Y, Matsuno T. Radiographic analysis of newly developed degenerative spondylolisthesis in a mean twelve-year prospective study. Spine (Phila Pa 1976). 2010;35(8):887‐891.
9. Guo M, Kong C, Sun S, Sun X, Li X, Lu S. Predictors of L4-L5 Degenerative Lumbar Spondylolisthesis: L4 Inclination Angle and Facet Joint Angle. World Neurosurg. 2019;130:e680‐e686.
10. Nakamae T, Nakanishi K, Kamei N, Adachi N. The correlation between sagittal spinopelvic alignment and degree of lumbar degenerative spondylolisthesis. J Orthop Sci. 2019;24(6):969‐973.
11. Chakravarthy V, Patel A, Kemp W, Steinmetz M. Surgical Treatment of Lumbar Spondylolisthesis in the Elderly. Neurosurg Clin N Am. 2019;30(3):341‐352.
12. Watters WC 3rd, Bono CM, Gilbert TJ, et al. An evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spondylolisthesis. Spine J. 2009;9(7):609‐614.
13. Karsy M, Bisson EF. Surgical Versus Nonsurgical Treatment of Lumbar Spondylolisthesis. Neurosurg Clin N Am. 2019;30(3):333‐340.
14. Chan AK, Sharma V, Robinson LC, Mummaneni PV. Summary of Guidelines for the Treatment of Lumbar Spondylolisthesis. Neurosurg Clin N Am. 2019;30(3):353‐364.
15. Ilyas H, Udo-Inyang I Jr, Savage J. Lumbar Spinal Stenosis and Degenerative Spondylolisthesis: A Review of the SPORT Literature. Clin Spine Surg. 2019;32(7):272‐278.
16. Koenig S, Jauregui JJ, Shasti M, et al. Decompression Versus Fusion for Grade I Degenerative Spondylolisthesis: A Meta-Analysis. Global Spine J. 2019;9(2):155‐161.
17. Dijkerman ML, Overdevest GM, Moojen WA, Vleggeert-Lankamp CLA. Decompression with or without concomitant fusion in lumbar stenosis due to degenerative spondylolisthesis: a systematic review. Eur Spine J. 2018;27(7):1629‐1643.
18. Martin CR, Gruszczynski AT, Braunsfurth HA, Fallatah SM, O'Neil J, Wai EK. The surgical management of degenerative lumbar spondylolisthesis: a systematic review. Spine (Phila Pa 1976). 2007;32(16):1791-1798.
19. Försth P, Ólafsson G, Carlsson T, et al. A Randomized, Controlled Trial of Fusion Surgery for Lumbar Spinal Stenosis. N Engl J Med. 2016;374(15):1413-1423.
20. Oikonomidis S, Meyer C, Scheyerer MJ, Grevenstein D, Eysel P, Bredow J. Lumbar spinal fusion of low-grade degenerative spondylolisthesis (Meyerding grade I and II): Do reduction and correction of the radiological sagittal parameters correlate with better clinical outcome?. Arch Orthop Trauma Surg. 2020;140(9):1155-1162.
21. Bovonratwet P, Webb ML, Ondeck NT, et al. Management of Degenerative Spondylolisthesis: Analysis of a Questionnaire Study, Correlation With a National Sample, and Perioperative Outcomes of Treatment Options. Int J Spine Surg. 2019;13(2):169‐177.
22. Kelly JP, Alcala-Marquez C, Dawson JM, Mehbod AA, Pinto MR. Treatment of degenerative spondylolisthesis by instrumented posterolateral versus instrumented posterolateral with transforaminal lumbar interbody single-level fusion. J Spine Surg. 2019;5(3):351‐357.
23. Gottschalk MB, Premkumar A, Sweeney K, et al. Posterolateral Lumbar Arthrodesis With and Without Interbody Arthrodesis for L4-L5 Degenerative Spondylolisthesis: A Comparative Value Analysis. Spine (Phila Pa 1976). 2015;40(12):917-925.
24. Bernard F, Mazerand E, Gallet C, Troude L, Fuentes S. History of degenerative spondylolisthesis: From anatomical description to surgical management. Neurochirurgie. 2019;65(2-3):75‐82.
25. Xu S, Liow MHL, Goh KMJ, et al. Perioperative Factors Influencing Postoperative Satisfaction After Lateral Access Surgery for Degenerative Lumbar Spondylolisthesis. Int J Spine Surg. 2019;13(5):415‐422.







How to Cite

Akkawi I, Zmerly H. Degenerative Spondylolisthesis: A Narrative Review. Acta Biomed [Internet]. 2022 Jan. 19 [cited 2024 Jul. 16];92(6):e2021313. Available from: