A comprehensive guide to spondylolisthesis surgery

Researching your options for spondylolisthesis treatments? This Laser Spine Institute article can help.

By Michael Perry, M.D.

If you have been diagnosed with spondylolisthesis, and you have exhausted conservative treatment options with no relief from your symptoms, you may be recommended for spine surgery. Before you undergo spondylolisthesis surgery, you should research the surgical options available to you. Surgical treatments like traditional open back surgery and minimally invasive spine surgery may have the same goals, but the techniques used during each procedure are significantly different.

Take a moment to read through the types of spondylolisthesis surgery available so you can make an informed decision about your spine care needs.

Understanding your options for spondylolisthesis surgery

Spondylolisthesis surgery may be an option for those who have tried conservative spondylolisthesis treatments but are still experiencing pain or limited mobility. The two main types of surgery used to treat spondylolisthesis symptoms are decompression procedures — such as a laminectomy or laminotomy — and spinal fusions.

Decompression surgery for spondylolisthesis

Often, the pain caused by spondylolisthesis is a result of bone matter, disc material or other tissues in the spinal canal pressing against a nerve. During a decompression surgery for spondylolisthesis, a surgeon will remove the source of the pressure on the nerve root or spinal cord, thereby releasing these nerves and alleviating the pain and other symptoms that they cause.

At Laser Spine Institute, our surgeons perform minimally invasive decompression surgery that may be used to treat spondylolisthesis and other spinal abnormalities. These procedures include:

  • Discectomy. A procedure that removes a portion of a damaged disc to relieve pressure from a neighboring nerve root or the spinal cord. Our minimally invasive approach involves making a small incision and carefully removing the offending material.
  • Laminotomy. A minimally invasive procedure involving the removal of a portion of the lamina, which is the roof of a vertebra. This process can be used to make more space in the spinal canal for the spinal cord or nerve roots. Laser Spine Institute does not perform laminectomies, which entail the removal of both of the lamina on a vertebra. These sections of bone make up the vertebral arch and normally sheath the spinal column. Removing the entire arch to create additional space is, accordingly, an invasive procedure that requires large incisions and a lengthy recovery process.
  • Foraminotomy. A procedure that consists of removing excess bone or other tissue that is narrowing a foramen (a space between spinal vertebrae through which nerve roots run) and compressing a nerve root. Removing these materials can alleviate the neck or back pain as well as radiating symptoms caused by the nerve compression.
  • Facet thermal ablation. A procedure that involves deadening a painful nerve within a facet joint. This approach is similar in function to a dental root canal, and it can relieve the pain caused by the irritated nerve.

Stabilization surgery for spondylolisthesis

The second kind of spondylolisthesis surgery, a spinal fusion, is performed to reposition a slipped vertebra and stabilize it in place, thereby strengthening the spine and lifting vertebral bone and disc tissue off a nerve root or the spinal cord.

At Laser Spine Institute, our surgeons can perform several types of minimally invasive stabilization procedures for patients who have more advanced spinal degeneration, like spondylolisthesis that causes nerve compression. Our surgery options include:

  • Decompression with Interlaminar Stabilization™ Device. A procedure in which the surgeon relieves the pressure placed on compressed nerve roots or the spinal cord by surrounding vertebrae, and enhances spinal stability by inserting a coflex© device – a flexible titanium implant.
  • Anterior cervical discectomy fusion (ACDF). During this procedure, the surgeon removes a damaged disc located in the cervical (upper) spine, and then fuses the adjacent vertebrae together in order to re-stabilize the spinal column. This surgery is performed through a small incision made in the front of the neck.
  • Posterior cervical fusion. Similar to the anterior cervical discectomy fusion (ACDF) procedure, this procedure fuses two neck vertebrae together to alleviate pain and provide better support for the spine. The surgeon performs the procedure from the back of the neck, accessing the spine through a small incision.
  • Cervical disc replacement. During this procedure, the surgeon removes a deteriorated cervical disc and replaces it with an artificial disc to reestablish the flexibility and strength of the spine.
  • Transforaminal lumbar interbody fusion (TLIF). This minimally invasive surgery consists of a surgeon fusing adjacent lumbar vertebrae together to enhance spinal stability.
  • Lateral lumbar interbody fusion (LLIF). Similar to a TLIF, this procedure involves a surgeon fusing together lumbar vertebrae, but it is performed through an incision on the side of the torso rather than in the middle, directly above the spine.
  • Sacroiliac (SI) joint fusion. A surgeon fuses a section of the pelvis, known as the ilium, to the lowest section of the spine, which is called the sacrum. This surgery can be used for spondylolisthesis patients, depending on the extent of their vertebral slippage.

Open spine surgery for spondylolisthesis

Decompression surgery and spinal fusion surgery for spondylolisthesis also can be performed via an open spine approach. Traditional open spine surgery comes with some negative side effects, and is generally performed in a hospital. These surgeries involve large incisions and damage to muscle tissue, so the recovery time can be lengthy. In most cases, patients must stay in the hospital for a few days before they are cleared to leave.

Due to the nature of traditional procedures and the necessity of a hospital stay, traditional open spine spondylolisthesis surgery options also have an increased risk of infections and complications when compared to the minimally invasive procedures offered by our team at Laser Spine Institute. Traditional open back spondylolisthesis surgery has an infection rate of up to 19 percent, while the outpatient procedures at Laser Spine Institute have a 0.49 percent rate.^

Our surgeons at Laser Spine Institute perform minimally invasive spine surgery as an alternative to open back spondylolisthesis surgery and other traditional open back surgeries. At Laser Spine Institute, our outpatient procedures use a less than 1-inch incision to treat a wide range of conditions affecting the neck and back, but with less pain and quicker recovery time^ compared to traditional open back surgery. The minimally invasive decompression and stabilization procedures performed at Laser Spine Institute are completed on an outpatient basis.

Our procedures are also completed using small incisions in the neck or back and muscle-sparing techniques. Utilizing a minimally invasive approach helps to minimize scarring and reduce the recovery times^ associated with our procedures. In fact, about 81 percent of our patients report that they are able to return to work within three months of undergoing surgery for most spinal conditions at Laser Spine Institute.

If you would like to learn about Laser Spine Institute’s minimally invasive spondylolisthesis surgery procedures, contact us for a no-cost review* of your MRI to determine if you may be a candidate for one of our procedures.