Treatment
The appropriate treatment of patients with isthmic spondylolisthesis is just as controversial as the cause of symptoms. Patients with isthmic spondylolisthesis are usually divided into two general classes for both treatment and for study: low grade isthmic spondylolisthesis (<50% slip) and high grade isthmic spondylolisthesis (>50% slip). Patients with low grade spondylolisthesis are usually young adults (90% adults and 10% adolescents) who present with low back pain and often with radiculopathy. High grade spondylolisthesis may also present with back pain, but may also present with cosmetic deformity, hamstring tightness, radiculopathy, abnormal gait, or it may be asymptomatic.
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