This classification review describes the Meyerding grading system for spondylolisthesis — how it was developed, how slip percentage is measured on standing lateral radiographs, and how the five-grade scale is used for communication, progression tracking, and treatment guidance. It also examines reliability data and the system's known limitations as a standalone prognostic tool.
When grading spondylolisthesis, use the Meyerding system to communicate severity and track progression — but when deciding on surgery for a low-grade slip, recognize that grade alone won't tell you who will progress; you need instability on dynamic films, etiology, sagittal alignment, and symptom trajectory to make that call.
This classification review describes the Meyerding grading system for spondylolisthesis — how it was developed, how slip percentage is measured on standing lateral radiographs, and how the five-grade scale is used for communication, progression tracking, and treatment guidance. It also examines reliability data and the system's known limitations as a standalone prognostic tool.
When grading spondylolisthesis, use the Meyerding system to communicate severity and track progression — but when deciding on surgery for a low-grade slip, recognize that grade alone won't tell you who will progress; you need instability on dynamic films, etiology, sagittal alignment, and symptom trajectory to make that call.