Degenerative Spondylolisthesis

Question 1

How is degenerative spondylolisthesis differentiated from adult isthmus spondylolisthesis?

Answer 1

degenerative does not have a pars defect
Also most common at L4/L5 level (adult isthmic is L5/S1)
8 times more common in females

Question 2

What muscles/movements are weak with L4 impingement?

L5 impingement?

Answer 2

L4- Quads, ankle dorsiflexion (can also be L5)

L5- abduction (glutes)

Question 3

What is a common presentation of degenerative spondylolisthesis?

Answer 3

Mechanical back pain relieved with sitting. Claudication not relieved by standing still (vascular), must sit down for relief.

Question 4

What is the treatment for degenerative spondylisthesis that has failed 6 months of conservative treatment?

Answer 4

Posterior decompression and instrumented fusion

Question 5

What patient cohort has worse outcomes with lumbar fusion for degenerative spondylisthesis?

Answer 5

Smokers