Radiological and Clinical Outcome of Non Surgical Management for Pediatric High Grade Spondylolisthesis

Objective: To describe and compare the quality of life of patients with pediatric high-grade spondylolisthesis managed non-operativelyand operatively. Summary of Background Data: Some authors consider pediatric high-grade spondylolisthesis as an absolute indication for surgery, regardless of symptomswhile others sometimes recommend observation in asymptomatic patients. Very little is known about the indications and outcome of non-operatively managed high-grade spondylolisthesis. Methods: A prospective database comprising all the spondylolisthesis cases from a single pediatric institution was reviewed in order to identify all cases of high gradespondylolisthesis. Quality of life data from Short form (SF)-12 and Scoliosis Research Society (SRS)-22 questionnaires were collected. Non-operatively treated patients were identified and compared to surgically treated patients at baseline and at last follow-up. Results: 34 spondylolisthesiswere identified as high grade and 5 of them were non-operatively treated. Quality of life questionnaires showed less impairment in the non-operativegroup when compared to the surgical group preoperatively. Moreover at last follow-up, quality of life questionnaires were similar between the two groups. There was no worsening of quality of life observed in non-operativepatients during follow-up. Conclusion: The quality of life after surgical treatment of high grade spondylolisthesisissimilar to that of patients with high grade spondylolisthesis and mild symptoms undergoing non–operative treatment.