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Physical therapy is the first line of treatment for adults with symptoms fromdegenerative spondylolisthesis. Surgical management is offered whennonoperative options have not adequately relieved symptoms. We performed PubMedliterature search with the word 'spondylolisthesis', and updated till September18, 2016. We selected original research data involving surgical treatment ofdegenerative spondylolisthesis, and in total there were n articles, includingdata reported from Japan (n=37 series), South Korea (n=11 series), mainlandChina (n=5 series), and ROC (Taiwan, n=3 series), America (n=20 series), Europe(n=23 series). The mean age of each study were extracted and used a singleentry. We tried our best to filter out double/multiple reported data. Ourresults showed the median age of degenerative spondylolisthesis patientsunderwent surgical treatment was 66 years in Japan, 60 years in South Korea, 59years in mainland China, 59 years in ROC (Taiwan), 65 years in USA, and 66years in Europe. This study indicates Japan and South Korea may have differentsurgical practice pattern. It will be of interested to investigate whether moreproportion of degenerative spondylolisthesis patients have been treatedsurgically in South Korea than in Japan. The cost-effectiveness of differentapproaches may warrant further analysis by professional spine surgeons.

South Korean degenerative spondylolisthesis patients had surgical  treatment at earlier age than Japanese, American, and European patients: a  published literature observation