Degenerative Spondylolisthesis is a spinal condition that results in one vertebrae slipping on the one below it. The resulting pain may be situated in the back or the legs from spinal stenosis. The condition is not life threatening and can be treated nonoperatively. It is a quality of life decision when it comes to operative intervention. Typically the slippage occurs of L4 on L5, but it can be at multiple levels as well.
If nonoperative treatments fail, surgery is offered as a last resort. The typical spine surgery for degenerative spondylolisthesis involves a decompressive surgery to free up any nerves that are being pinched. This is called a decompressive laminectomy. In addition to freeing up nerves, the surgery usually involves stabilizing the one vertebrae on the other. This is done with a spinal fusion and may involve screws and rods placed in the bones on one or both sides of the unstable level.
It is not necessary to reduce the slippage as freeing up the nerve roots directly will decompression the pinching and often times it is more trouble than its worth. In addition, bone graft material is placed on each side of the spine in order to facilitate fusion of one level to another.
Does the surgery have good results? The answer is a definitive yes. In the world of spine surgery, procedures for degenerative spondylolisthesis have overall very favorable outcomes. Patients typically spend one to 3 nights in the hospital, and the surgery works well for resolution of both back and leg pain.
Unlike many types of spine surgery that have questionable outcomes, spinal decompression and fusions for degenerative spondylolisthesis work typically very well. Once again, it is a last resort procedure quality of life decision.
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