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Treatment of spondylolisthesis
Last reviewed: 06.07.2025
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Conservative treatment of spondylolisthesis is indicated for patients with grades I-II spondylolisthesis in the absence of neurological deficit. Axial loads on the spine are excluded. NSAIDs (naproxen, diclofenac, ibuprofen), B vitamins, physiotherapy, exercise therapy aimed at strengthening the long muscles of the back and the anterior abdominal wall are prescribed. When performing any physical work, wearing a semi-rigid corset is recommended. Indications for surgical treatment of spondylolisthesis:
- neurological disorders of compression genesis against the background of spinal canal stenosis or chronic trauma to the root:
- lumbago due to instability of the spinal motor segment;
- spondyloptosis;
- progressive displacement of the vertebra;
- ineffectiveness of conservative treatment for 6 months.
The tasks of surgical treatment of spondylolisthesis are divided into two groups.
- The first group is orthopedic:
- reduction of the L5 vertebral body and stabilization of the lumbosacral segment of the spine in the achieved position;
- restoration of the sagittal and frontal profiles of the lumbosacral spine.
- The second group is neurosurgical:
- pain relief;
- elimination of vertebral-spinal conflict;
- restoration of the anatomy of the spinal canal.
- Modern surgical interventions include:
- removal of the arch of a displaced vertebra;
- transpedicular fixation and reduction of the body of the displaced vertebra;
- revision of the spinal canal and radiculolysis;
- discectomy and interbody corporodesis with autobone at the pathological level;
- posterior local spondylodesis with autogenous bone.