Overview
Acquired spondylolisthesis of the cervical vertebra involves the forward or backward displacement of a vertebra relative to its adjacent vertebra, often due to degenerative changes affecting the facet joints and intervertebral discs 12.Diagnosis
Key Diagnostic Criteria: Identification of vertebral slippage on imaging, typically MRI or CT myelography 12.
Recommended Tests: Kinematic MRI to assess motion, disc degeneration, and Space Available for Cord (SAC) at the affected and adjacent levels 1.
Grading: Commonly graded based on the degree of slippage (e.g., Meyerding classification) 1.Management
First-Line Treatments: Conservative management including physical therapy, cervical bracing, and activity modification 1.
Adjunctive Treatments: Epidural steroid injections for radiculopathy symptoms (specific drug classes not detailed in abstracts) 1.
Surgical Intervention: Considered for progressive neurological deficits, severe pain unresponsive to conservative measures, or significant spinal instability 1.Special Populations
Pediatrics: Rare but reported cases show stability over time; long-term observation may be sufficient 3.
Elderly: Management often focuses on minimizing surgical risks and optimizing conservative therapies due to comorbidities 1.Key Recommendations
Utilize kinematic MRI for comprehensive evaluation of motion, disc degeneration, and SAC in patients with degenerative cervical spondylolisthesis to guide treatment decisions (Evidence: Moderate) 1.
Prioritize conservative management strategies initially, including physical therapy and cervical bracing, before considering surgical interventions (Evidence: Expert opinion) 1.
Monitor pediatric cases closely; stability without progression over time supports conservative management approaches (Evidence: Weak) 3.References
1 Paholpak P, Nazareth A, Barkoh K, Lee LV, Lucas J, Buser Z et al.. Space Available for Cord, Motion, and disc degeneration at the adjacent segments level of degenerative cervical spondylolisthesis using kinematic MRI. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia 2017. link
2 Paholpak P, Nazareth A, Hsieh PC, Buser Z, Wang JC. Kinematic evaluation of cervical sagittal balance and thoracic inlet alignment in degenerative cervical spondylolisthesis using kinematic magnetic resonance imaging. The spine journal : official journal of the North American Spine Society 2017. link
3 Hanai K, Miyashita T, Saburi H. Cervical spondylolisthesis. Acta orthopaedica Scandinavica 1976. link