Treatment of Multilevel Anterior and Retrolisthesis of the Lumbosacral Spine

Instability of the adult lumbosacral spine, commonly due to degenerative spondylolisthesis and post-laminectomy instability, affects single levels more frequently than multiple levels [1–6]. Treatment options applied to single-level instability have been applied to multiple-level instability, with the cornerstone of treatment being decompression. Notwithstanding the consensus on the need for decompression, the extent necessary is controversial, as are the indications for concurrent fusion, deformity correction, and the use of instrumentation [1,4,5,7–24].