Poster Presentation 51st International Society for the Study of the Lumbar Spine Annual Meeting 2025

INTRODUCTION

Lumbar anterolisthesis (LA) is a spondylolisthesis of the lumbar spine characterized by the anterior translational displacement of one vertebra in relation to the vertebra beneath it. Lumbar spondylolisthesis (LS) affects up to 31% of the US population and is described in literature as a progressive, degenerative condition with no corrective options. Non-surgical and surgical options may help with symptoms; however, many surgical cases are met with complications with over 10% of patients undergoing additional or revision surgery(ies). LS contributes to chronic spine pain which is an indicator for dysfunction, disability, and decreased quality of life (QOL) and accounts for the greatest global burden of disease and years lived with disability. Although non-surgical treatments for spondylolisthesis remains scarce in the literature, Fedorchuk, et al. have reported on patients receiving a non-surgical, corrective spinal rehabilitation protocol (Chiropractic BioPhysics® (CBP®)) resulting in successful corrections of LS.

METHODS

This study analyzed 117 patients with LAs to assess the impact of CBP® treatment on anterior segmental translation (+Tz) of LS and physical and mental QOL measures using the SF-36 questionnaire. The primary outcomes included +Tz measurements at six intervertebral levels (Tz T12-S1) and an overall mean Tz of LA at all spinal levels. Each LA was classified using the Meyerding classification system based on predefined ranges (Grade I = 4.0 to 8.9 cm, Grade II = 9.0 to 17.8 cm, Grade III = 17.9 to 26.7 cm, Grade IV = 26.8 to 35.6 cm, and Grade V = >35.6 cm). Pre- and post-treatment values were recorded and evaluated. For each intervertebral level and overall mean, paired t-tests were performed to compare pre- and post-treatment values. Statistical significance was set at a 95% confidence level (p<0.05).

RESULTS

The sample included 117 individuals (54 males [46.2%] and 63 females [53.8%], mean age of 55.77±15.19 years, mean height of 173.6±5.46 cm, and mean weight of 82.50±3.62 kg. Participants received a mean 42.89±20.12 treatment visits over 22.05±12.90 weeks at a rate of 2.14±0.56 treatment visits per week. The results of the paired t-tests for pre- and post-treatment comparisons across different grades showed significant reductions in Grade I-III LA measurements across all spinal levels. For mean Tz, Grade I (N=85) improved from 6.17±1.32 mm to 2.58±1.34 mm (p<0.0001), Grade II (N=38) improved from 11.69±1.97 mm to 5.85±2.15 mm (p<0.0001), and Grade III (N=4) improved from 19.18±0.81 mm to 14.30±1.88 mm (p=0.0064). Pre- and post-treatment SF-36 scores showed significant improvement in physical and mental component summaries, physical functioning, and bodily pain QOL scores.

DISCUSSION

The results indicated that Grade I-III LA showed statistically significant improvements across all spinal levels. There were no Grade IV or V LA to compare. The overall mean Tz confirmed a significant treatment effect across the entire cohort. These findings indicate consistent improvements in post-treatment Tz measurements in patients with Grade I-III LAs with notable statistical significance across multiple comparisons. This case documents the first robust case series documenting improvements in physical and mental QOL following reduction of Grade I-III LA using CBP® corrective spinal rehabilitation.