DEGENERATIVE LUMBAR SPONDYLOLISTHESIS - A METAANALYSIS OF LITERATURE 1970-1993

Degenerative spondylolisthesis is a distinct clinical entity characterized by degenerative arthritis of the facet joints in association with disc degeneration. Erosion and remodeling of the facet joint complex allows anterolisthesis of the cephalad on the caudad lumbar vertebra.20 The pathoanatomic elements of facet joint arthritis, anterolisthesis, disc height loss, and ligamentum flavum redundancy all contribute to the development of spinal stenosis involving to a variable degree the central canal, lateral recess, and foraminal zones.24 The clinical presentation of patients is one of a long history of back pain with insidious onset of radicular leg pain and/or neurogenic claudication. This condition is recognized as the classic example of chronic lumbar instability.17 It occurs with greater frequency in blacks and females and is rare before 35 years of age. The most common level is L4-L5 followed by L3-L4 and L5-S1. The presence of a pars interarticularis defect excludes the diagnosis of degenerative spondylolisthesis.7 This study was designed and executed in an attempt to collect and analyze the published data on degenerative spondylolisthesis to evaluate the feasibility of its use as a literature control to compare with the Historical Cohort pedicle screw study data.