• Moon Soo Park, Seong-Hwan Moon, Jae Keun Oh, Ho Won Lee, and K Daniel Riew.
• Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University, Gyeonggi-do, Republic of Korea.
• Spine. 2019 Jan 1; 44 (1): E7-E12.

Study DesignRetrospective observational and case-control study.ObjectiveTo determine the risk factors for progression of degenerative listhesis by comparing patients with and without progression at greater than 5-year follow-up.Summary Of Background DataThe previous study with 2- to 7-year follow-up showed that degenerative spondylolisthesis of the cervical spine did not progress. Longer-term follow-up may reveal that these patients actually do progress over time.MethodsWe identified 218 patients with greater than 5-year follow-up without surgery. They were categorized as either having or not having cervical spondylolisthesis. We defined spondylolisthesis as the presence of greater than 2 mm of translation in standing neutral lateral radiographs of the cervical spine at the initial evaluation. The control group at baseline was those without spondylolisthesis. Progression of translation was defined as greater than 2 mm of additional translation on the final standing neutral radiograph.ResultsThe mean follow-up duration was 6.4 ± 1.0 years (range: 5-9.4 yr). Progression of translation was found in 20 patients (9.2%), including 4 patients in the spondylolisthesis group and 16 patients in the control group. Progression of translation was not related to the presence of spondylolisthesis or the severity of translation at the initial evaluation, but was more common in the elderly and in the patients with anterior translation than those with posterior translation at the initial evaluation. In addition, progression of spondylolisthesis was not correlated with any change of symptoms.ConclusionProgression of cervical spondylolisthesis is not related to the presence of spondylolisthesis at baseline.Level Of Evidence4.

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