To determine whether cervical degenerative spondylolisthesis is unstable and/or progresses.
Cervical degenerative spondylolisthesis is relatively common in the elderly. However, there are no reports regarding its natural history.
We identified 27 patients with cervical degenerative spondylolisthesis (3.9%) from a database of 697 patients, using cervical radiographs. All had neutral and dynamic lateral radiographs at baseline and at a minimum of 24 months later (mean 39 mo, range, 24–92 mo). The mean age of the patients at the initial visit was 59.0 years (range, 50–83 yr). Male to female ratio was 16:11. Radiographical findings and clinical symptoms related to spondylolisthesis were assessed at initial and final follow-up.
Eleven patients had cervical spondylolisthesis at C4–C5, 9 at C3–C4, 6 at C5–C6, and 1 at C2–C3. Initially, 6 had anterolisthesis and 21 had retrolisthesis. At baseline, 3 of 6 patients with anterolisthesis and 7 of 21 patients with retrolisthesis had translation of more than 2 mm on dynamic views. At baseline, 11 had no cervical symptoms, 8 had cervicalgia, 7 had radiculopathy, and 1 had myelopathy. At the final visit, none of the anterolistheses or retrolistheses had progressed. At the final visit, 7 of 10 patients with initial translation of more than 2 mm on dynamic views had no change. Of 17 patients with less than 2 mm of initial dynamic motion, 3 patients progressed to have more than 2 mm of dynamic translation. All 3 of these had retrolisthesis initially. None had clinical worsening of symptoms at the final visit.
The natural history of cervical degenerative anterolisthesis and retrolisthesis seems to be stable during 2 years to nearly 8 years. Although those with retrolisthesis seem to have a higher propensity to increase their subluxation, none experienced dislocation or neurological injury.
Level of Evidence: 4
In a retrospective radiographical study of 27 patients with cervical degenerative spondylolisthesis, none of the anterolistheses or retrolistheses had progressed at the final visit. In summary, the natural history of cervical degenerative spondylolisthesis seems to be stable during 2 to nearly 8 years.
*Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University, Pyeongchon-dong, Dongan-gu, Anyang-si, Gyeonggi-do, Republic of Korea
†Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea; and
‡Department of Orthopedic Surgery, Washington University School of Medicine, St. Louis, MO.
Address correspondence and reprint requests to Moon Soo Park, MD, PhD, Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University, 896, Pyeongchon-dong, Dongan-gu, Anyang-si, Gyeonggi-do, 431-070, Republic of Korea; E-mail: firstname.lastname@example.org
Acknowledgment date: October 5, 2012. First revision date: November 4, 2012. Acceptance date: November 9, 2012.
The manuscript submitted does not contain information about medical device(s)/drug(s).
No funds were received in support of this work.
Relevant financial activities outside the submitted work: expert testimony, board membership, royalties.