Long-term pain relief significantly improved in both the PLF and the PLIF treatment groups in the three studies. Surgical interventions include decompression, posterior and posterolateral lumbar arthrodesis, and circumferential fusion. Workers have significantly better outcomes than non-working adults in multi-variate analysis. The health-related quality of life (QOL) of adults with high-grade spondylolisthesis significantly improves after surgical intervention. After adults fail to respond to 3–6 months of non-surgical treatment, surgical intervention is considered for relief of continual disruptive back pain or radicular pain, loss of nerve function, as well as for symptomatic grade III or greater slip, progressive deformity, and development of cauda equine. These non-surgical treatments combined with anti-lordotic bracing can provide sufficient benefit to more than 75% of adults with grade I–II spondylolisthesis.
Patients with physical complaints and mild spondylolisthesis initially are treated with non-surgical modalities including prescriptions for non-steroidal anti-inflammatory drugs (NSAIDs), physical therapy, and modification of their activities that induce pain and rest for 1–2 weeks.
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