Dr. Shiltenwolf,

Prior to any surgical intervention for low back pain the following psychosocial variables should be assessed: depression, self-efficacy, catastrophization/fear-avoidance and, for those injured on the job, a poor relationship with one's employer or job dissatisfaction.

Other than clinical depression, these are not psychological "disorders" per se, but each of them has a varying degree of association with poor outcome from an episode of low back pain.

I think you should also take into account that neither disc prolapse (except where correlated with clinical signs and symptoms of nerve root compression) nor spondylolisthesis have shown to predict disability due to low back pain.

I recommend this review by Turk and Okifuji on psychological factors in chronic pain.

http://psycnet.apa.org/index.cfm?fa=search.displayRecord&uid=2002-01415-015

I agree with John Ware as far as different psychsocial variables should be taken into consideration when surgery for spondylolisthesis grade I and II is discussed. I would add some psychiatric conditions (bipolar disorder, schizophrenia, etc.) that can make the decision making more difficult. Of course the guidelines should be based first of all on the severity of complaints, physical examination (neurologic deficit ?), imaging diagnostics, response to conservative treatment. Spondylolisthesis grade II is usually associated with neurologic deficit (present or imminent), and especially in younger patients surgical decompression and stabilization should be recommended.

yours comments agree to my opinion. However this is common knowledge dealing with chronic pain in general. I am searching for specific reports on psychosocial variables in (low grade) spondylolisthesis.

dear dr. Schiltenwolf, 

As low grade listhesis is just one of the many manifestations of growth disturbances based on postural misdevelopment ( neuro-osseous growth relations) there will be no spondylolisthesis dependant or conjoined psychosocial factors. 

The even more variated psychosocial status of people in western societies has its etiologic factors in the complete uniqueness of the development of the locomotor system in individual children ( time for play, gymnastics, Maxi Cosy hours, sitting hours, slumping hours, TV hours, walking , biking etc. etc. ) and the individusl or time-area changing habits in guidance by adults of these processes. 

In all cases I saw, the tight contactzones betweenn the roots and the pedicles, Foraminae, but also the tilted lamina of L5 or S1 give rise to neurological complaints. 

Conservatieve means, like postural excersises , improvement muscular condition of the upperbody and change to only actve sitting can do a lot, so surgery can be prevented or postponed to older ages. 

You are right. active coping supports better living with our physical conditions. Nevertheless we do not know who will active cope and who will not. This has to be understood before tailoring rehabilitations programs for persons in chronic pain with Olisthesis as well.