Traumatic lumbar spondylolisthesis: current concepts and a literature review

Abstract

The aim of the study was to review published literature on traumatic lumbar spondylolisthesis. Traumatic spondylolisthesis of the lumbosacral region is a relatively rare but serious spinal injury necessitating careful clinico-radiological evaluation and management for a successful outcome. Limited literature is available to date to guide clinicians to treat the injury comprehensively. This article analyses the published literature and promulgates an evidence-based management plan for this injury. PubMed, Cochrane, Scopus, Google Scholar databases were searched using the keywords “traumatic lumbar” AND “spondylolisthesis” following PRISMA guidelines. In total, 118 relevant articles were considered for full-text review; among them, 68 articles were finally selected for the analysis. In each article, the pathomechanism; clinical and radiological features; classifications; indications for nonoperative and operative management; operative approaches, techniques, and rehabilitation; and long-term outcomes were analyzed. Traumatic lumbar spondylolisthesis is high-energy spine trauma requiring thorough evaluation. Radiographs are the initial investigation technique used in the emergency department, computed tomography scans define the bony details of the injury, and magnetic resonance imaging is important for deciding the treatment protocol depending on the disc injury. Decompression and instrumented fusion are the standard treatment protocol. A satisfactory outcome is to be expected in the majority of cases.