Contemporary management of isthmic spondylolisthesis: pediatric and adult

BackgroundIsthmic spondylolisthesis is common in pediatric and adult patients. Most cases are asymptomatic. When symptomatic, nonsurgical treatment is an appropriate first step. Surgical treatment of this condition varies depending on patient age, degree of slip, presence of neurologic findings, and degree of deformity.PurposeTo review the literature on the management of isthmic spondylolisthesis in pediatric and adult patients.Study DesignReview article.MethodsLiterature review.Results and ConclusionsAchieving a solid fusion leads to improved functional outcomes and reduction in pain. A circumferential fusion is associated with a higher fusion rate and has become more common, especially with high-grade slips. The need for reduction is controversial and is mostly indicated for patients with significant lumbosacral kyphosis and sagittal imbalance.