Cervical degenerative spondylolisthesis is relatively common in the elderly.

The CDS group was characterized by a greater T1 slope than the control group; therefore, Jun et al. suggest that a high T1 slope may be a predisposing factor in developing CDS 1).

However, there are no reports regarding its natural history.

Park et al. identified 27 patients with cervical degenerative spondylolisthesis (3.9%) from a database of 697 patients, using cervical radiographs. All had neutral and dynamic lateral radiographs at baseline and at a minimum of 24 months later (mean 39 mo, range, 24-92 mo). The mean age of the patients at the initial visit was 59.0 years (range, 50-83 yr). Male to female ratio was 16:11. Radiographical findings and clinical symptoms related to spondylolisthesis were assessed at initial and final follow-up.

Eleven patients had cervical spondylolisthesis at C4-C5, 9 at C3-C4, 6 at C5-C6, and 1 at C2-C3. Initially, 6 had anterolisthesis and 21 had retrolisthesis. At baseline, 3 of 6 patients with anterolisthesis and 7 of 21 patients with retrolisthesis had translation of more than 2 mm on dynamic views. At baseline, 11 had no cervical symptoms, 8 had cervicalgia, 7 had radiculopathy, and 1 had myelopathy. At the final visit, none of the anterolistheses or retrolistheses had progressed. At the final visit, 7 of 10 patients with initial translation of more than 2 mm on dynamic views had no change. Of 17 patients with less than 2 mm of initial dynamic motion, 3 patients progressed to have more than 2 mm of dynamic translation. All 3 of these had retrolisthesis initially. None had clinical worsening of symptoms at the final visit.

The natural history of cervical degenerative anterolisthesis and retrolisthesis seems to be stable during 2 years to nearly 8 years. Although those with retrolisthesis seem to have a higher propensity to increase their subluxation, none experienced dislocation or neurological injury 2).

Cervical degenerative spondylolisthesis in C4-C5

Jun HS, Kim JH, Ahn JH, Chang IB, Song JH, Kim TH, Park MS, Kim YC, Kim SW, Oh JK. T1 slope and degenerative cervical spondylolisthesis. Spine (Phila Pa 1976). 2015 Feb 15;40(4):E220-6. doi: 10.1097/BRS.0000000000000722. PubMed PMID: 25423304.
Park MS, Moon SH, Lee HM, Kim SW, Kim TH, Suh BK, Riew KD. The natural history of degenerative spondylolisthesis of the cervical spine with 2- to 7-year follow-up. Spine (Phila Pa 1976). 2013 Feb 15;38(4):E205-10. doi: 10.1097/BRS.0b013e31827de4fd. PubMed PMID: 23169076.
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