The Orthobullets Podcast Foundations | Spine | Degenerative Spondylolisthesis
Dec 8, 2025
Explore the intriguing world of degenerative spondylolisthesis, from its definition to how it affects nerve roots. Discover the degenerative cascade and the importance of imaging protocols in diagnosis. Get insights into clinical presentations and first-line nonoperative treatments. Learn about surgical options and the evidence supporting better outcomes for patients. Finally, delve into specific cases, including postoperative complications and strategies to prevent positioning injuries.
AI Snips
Chapters
Transcript
Episode notes
Core Definition And Diagnosis
- Degenerative spondylolisthesis is anterior vertebral subluxation with an intact pars most common at L4-L5 in women over 40.
- Diagnosis uses lateral radiographs and flexion-extension films to assess instability.
Why Slips Happen
- Facet degeneration, sagittal facet orientation, disc wear, and ligamentous laxity drive forward slip.
- Sagittally oriented facets particularly permit progression from micro- to macro-instability.
How Nerve Roots Are Affected
- Neurologic symptoms arise from central, lateral recess, or foraminal stenosis.
- L4-L5 slip can compress the descending L5 root in the recess and the L4 root in the foramen.