# Meyerding — Meyerding grading of spondylolisthesis

> Grades vertebral slip by percentage.

**Situação:** vigente · **Órgão:** Coluna · **Órgão emissor:** Orthopedic consensus · **Versão:** 1932 · **Ano:** 1932

## Procedência e vigência
- Família: léxico
- Tipo de lógica: flat
- Modalidade: XR, MRI
- Fonte primária: Meyerding HW. Spondylolisthesis (Meyerding grading) (1932) — https://en.wikipedia.org/wiki/Spondylolisthesis
- Última verificação: 2026-06-26
- Última checagem: 2026-06-26

## Categorias

| Código | Rótulo | Critérios | Conduta | Risco | Localizador | Verificado |
| --- | --- | --- | --- | --- | --- | --- |
| I | Grade I (0-25%) | Anterior translation of the slipped vertebra measuring roughly 1% to 25% of the adjacent vertebral body width. A low-grade slip (Grade I-II = under 50%). | Nonoperative care is first-line for low-grade slips: activity modification, physical therapy/core strengthening, and analgesia. Surgery (decompression usually combined with fusion) is reserved for persistent pain refractory to conservative treatment, neurologic deficit, or progressive slip; only about 10%-15% of younger low-grade patients fail conservative management and need surgery. | Low-grade slips generally have a favorable prognosis with lower likelihood of progression than high-grade slips; most are managed successfully without surgery. | StatPearls NBK430767, Treatment/Management ('Nonoperative management is the first-line approach'; surgery for refractory pain, neurologic deficit, or progressive deformity; 'In low-grade cases, decompression, usually combined with fusion, is the standard surgical approach'; '10% to 15% of younger patients with low-grade spondylolisthesis will fail conservative treatment'). Grade I band corroborated by Wikipedia 'Spondylolisthesis', Severity (Grade I 0-25%). | ✓ |
| II | Grade II (25-50%) | Anterior translation of the slipped vertebra measuring roughly 26% to 50% of the adjacent vertebral body width. Still a low-grade slip (Grade I-II = under 50%). | As for Grade I: nonoperative management first-line, with decompression plus fusion reserved for refractory pain, neurologic deficit, or documented progression. The 50% slip boundary (between Grade II and III) marks the conventional transition from low-grade to high-grade and is a prognostically meaningful threshold. | Low-grade prognosis; lower progression risk than high-grade disease, though slips approaching the 50% threshold warrant monitoring for progression. | StatPearls NBK430767, Treatment/Management (same low-grade nonoperative-first, decompression+fusion approach); low-grade vs high-grade boundary at ~50% per Evaluation/management discussion. Grade II band corroborated by Wikipedia 'Spondylolisthesis', Severity (Grade II 25-50%). | ✓ |
| III | Grade III (50-75%) | Anterior translation of the slipped vertebra measuring roughly 51% to 75% of the adjacent vertebral body width. A high-grade slip (Grade III-V = over 50%). | High-grade slips are more likely to require surgery (decompression with instrumented fusion); reduction techniques are considered, particularly when there is an unbalanced/decompensated spinopelvic alignment. Nonoperative care may still be trialed for the asymptomatic or mildly symptomatic patient, but the surgical threshold is lower than for low-grade disease. | High-grade spondylolisthesis carries a more guarded prognosis owing to a higher likelihood of progression and of complications. | StatPearls NBK430767, Treatment/Management ('High-grade spondylolisthesis carries a more guarded prognosis due to the higher likelihood of progression and complications'; reduction 'strongly considered if a superimposed unbalanced spine is noted'). Grade III band corroborated by Wikipedia 'Spondylolisthesis', Severity (Grade III 50-75%). | ✓ |
| IV | Grade IV (75-100%) | Anterior translation of the slipped vertebra measuring roughly 76% to 100% of the adjacent vertebral body width. A high-grade slip (Grade III-V = over 50%). | High-grade management as for Grade III: instrumented decompression and fusion, with reduction considered for spinopelvic imbalance. Surgical correction of severe high-grade slips is technically demanding with higher complication rates. | Guarded prognosis with higher progression and complication risk characteristic of high-grade slips. | StatPearls NBK430767, Treatment/Management (high-grade guarded prognosis, reduction for unbalanced spine). Grade IV band corroborated by Wikipedia 'Spondylolisthesis', Severity (Grade IV 75-100%). | ✓ |
| V | Grade V, spondyloptosis | Slip greater than 100%, where the vertebra has fully translated off the one below it (spondyloptosis). The most severe high-grade slip. | Spondyloptosis is essentially a surgical problem: instrumented fusion with reduction or, in selected cases, vertebrectomy techniques are used to restore alignment. Carries the highest technical difficulty and complication profile. | Most guarded prognosis of the grades, with the greatest deformity, neurologic risk, and surgical complication potential. | StatPearls NBK430767, Treatment/Management (high-grade guarded prognosis and reduction considerations apply to the most severe slips). Grade V band corroborated by Wikipedia 'Spondylolisthesis', Severity (Grade V >100%). | ✓ |

### Citações por categoria
- **I**: Meyerding HW. Spondylolisthesis (Meyerding grading) (1932) — https://en.wikipedia.org/wiki/Spondylolisthesis · StatPearls NBK430767, Treatment/Management ('Nonoperative management is the first-line approach'; surgery for refractory pain, neurologic deficit, or progressive deformity; 'In low-grade cases, decompression, usually combined with fusion, is the standard surgical approach'; '10% to 15% of younger patients with low-grade spondylolisthesis will fail conservative treatment'). Grade I band corroborated by Wikipedia 'Spondylolisthesis', Severity (Grade I 0-25%).
- **II**: Meyerding HW. Spondylolisthesis (Meyerding grading) (1932) — https://en.wikipedia.org/wiki/Spondylolisthesis · StatPearls NBK430767, Treatment/Management (same low-grade nonoperative-first, decompression+fusion approach); low-grade vs high-grade boundary at ~50% per Evaluation/management discussion. Grade II band corroborated by Wikipedia 'Spondylolisthesis', Severity (Grade II 25-50%).
- **III**: Meyerding HW. Spondylolisthesis (Meyerding grading) (1932) — https://en.wikipedia.org/wiki/Spondylolisthesis · StatPearls NBK430767, Treatment/Management ('High-grade spondylolisthesis carries a more guarded prognosis due to the higher likelihood of progression and complications'; reduction 'strongly considered if a superimposed unbalanced spine is noted'). Grade III band corroborated by Wikipedia 'Spondylolisthesis', Severity (Grade III 50-75%).
- **IV**: Meyerding HW. Spondylolisthesis (Meyerding grading) (1932) — https://en.wikipedia.org/wiki/Spondylolisthesis · StatPearls NBK430767, Treatment/Management (high-grade guarded prognosis, reduction for unbalanced spine). Grade IV band corroborated by Wikipedia 'Spondylolisthesis', Severity (Grade IV 75-100%).
- **V**: Meyerding HW. Spondylolisthesis (Meyerding grading) (1932) — https://en.wikipedia.org/wiki/Spondylolisthesis · StatPearls NBK430767, Treatment/Management (high-grade guarded prognosis and reduction considerations apply to the most severe slips). Grade V band corroborated by Wikipedia 'Spondylolisthesis', Severity (Grade V >100%).


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