1 Introduction top
Asymptomatic patients should be observed and are not surgical candidates unless:
- Progressive listhesis
- High grade spondylolisthesis
Activity modification is recommended during painful episodes.
2 Physical therapy top
A course of physical therapy focussing on core muscle strengthening (erector spinae muscle, psoas, and rectus abdominis) is the key to conservative treatment.
3 Pain management top
Adjuvant medical treatment consisting of anti inflammatories, muscle relaxants may alleviate acute exacerbation of pain.
For children orthotic can also alleviate pain. A course of 6-12 weeks of a TLSO with thigh extension has been shown to be effective in pain relief.
A pars block consisting of local anesthetic (marcain) and steroids injection into / around the pars articularis has been shown to decrease pain. This can also be a diagnostic procedure confirming patients actual low back pain originates from the spondylolisthesis/spondylolysis.