Abstract：Objective To summarize the research progress on the classification of lumbar spondylolisthesis. Methods A total of 570 articles on the classification and staging of lumbar spondylolisthesis published from January 2000 to July 2022 were retrieved from Chinese and English databases such as CNKI, Wanfang Database, and Pubmed. Articles for which the full text could not be obtained or had inconsistent content and repetitive studies were excluded. A total of 38 articles were finally included. The types and stages of spondylolisthmia were summarized. Results Given that X-ray is easily affected by iliac occlusion, few X-ray-based staging methods exist. X-ray-based staging methods can be divided into three types in accordance with the characteristics of isthmus cracks. However, they are general. Classification in accordance with the true slip value and L5 development is accurate and can be divided into two types but has limited application value. Compared with X-ray, CT can evaluate the degree of lumbar spondylolysis more accurately and is superior in showing spondylolisthesis. CT stages can be divided into early, advanced, and terminal in accordance with the features of isthmic fissures shown by CT. Although the CT staging method can be used to detect lumbar isthmic spondylolisthesis at an early stage, it cannot be used to evaluate the subtle morphological changes presented by isthmic fissures. CT staging based on X-ray evaluation can be divided into very early, late early, advanced, and late stages in accordance with the characteristics of the isthmus of the vertebral pedicle. Among these stages, the early stage is the best time for conservative treatment. However, research on this staging method has limitations. CT staging based on X-ray evaluation can be divided into the nonslip, very early, late early, advanced, and terminal stages. This staging system can reflect the severity of spondylolisthesis accurately. MRI has advantages in revealing bone marrow edema and other soft tissue lesions. Lumbar isthmic spondylolisthesis can be classified into grades 0-5 in accordance with MRI imaging features. However, this classification method is ineffective in showing grade 2 spondylolisthmic spondylolisthesis. This situation may lead to missed diagnosis. The isthmus is divided into types A, BⅠ, BⅡ, and BⅢ on the basis of the appearance of the isthmus and its surrounding tissue on MRI. However, not every type is observed in disease progression. Staging based on the simultaneous use of X-ray, CT, and MRI can be divided into early, progressive, and advanced stages, and patients in the early and progressive stages should actively receive conservative treatment. The surgical classification of spondylolisthmia is important for clinical decision making. Conclusion Relevant research on the classification and staging of lumbar spondylolisthesis is mainly based on imaging techniques, such as X-ray, CT, and MRI, and different surgical methods. Different classification and staging systems can guide spinal surgeons to understand the formation mechanism of lumbar spondylolisthesis, predict progress, and develop treatment plans.
许星柱, 王辉, 丁文元. 腰椎峡部裂性滑脱分型和分期的研究进展[J]. 中华解剖与临床杂志, 2024, 29(2): 133-137.
Xu Xingzhu, Wang Hui, Ding Wenyuan. Research progress on the classification of lumbar isthmic spondylolisthesis. Chinese Journal of Anatomy and Clinics, 2024, 29(2): 133-137.
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2024, Vol. 29 
