DEGENERATIVE LUMBAR SPONDYLOLISTHESIS - A METAANALYSIS OF LITERATURE 1970-1993

Degenerative spondylolisthesis is a distinct clinical entity character ized 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.2 0 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 pr esentation of patients is one of a long history of back pain with insi dious onset of radicular leg pain and/or neurogenic claudication. This condition is recognized as the classic example of chronic lumbar inst ability.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 followe d by L3-L4 and L5-S1. The presence of a pars interarticularis defect e xcludes the diagnosis of degenerative spondylolisthesis.7 This study w as designed and executed in an attempt to collect and analyze the publ ished data on degenerative spondylolisthesis to evaluate the feasibili ty of its use as a literature control to compare with the Historical C ohort pedicle screw study data.