Authors of section

Author

Jean Ouellet

General Editor

Luiz Vialle

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Nonoperative

1. Introduction

Indications

Asymptomatic patients should be observed and are not surgical candidates unless:

  • Progressive listhesis
  • High grade spondylolisthesis

Activity modification

Activity modification is recommended during painful episodes.

2. Physical therapy

A course of physical therapy focussing on core muscle strengthening (erector spinae muscle, psoas, and rectus abdominis) is the key to conservative treatment.

3. Pain management

Adjuvant medical treatment consisting of anti inflammatories, muscle relaxants may alleviate acute exacerbation of pain.

For children orthotic can also alleviate pain. A course of 6-12 weeks of a TLSO with thigh extension has been shown to be effective in pain relief.

A pars block consisting of local anesthetic (marcain) and steroids injection into / around the pars articularis has been shown to decrease pain. This can also be a diagnostic procedure confirming patients actual low back pain originates from the spondylolisthesis/spondylolysis.

spondylolisthesis type 1