South Korean degenerative spondylolisthesis patients had surgical   treatment at earlier age than Japanese, American, and European patients: a   published literature observation
  Physical therapy is the first line of treatment for adults with symptoms from degenerative spondylolisthesis. Surgical management is offered when nonoperative options have not adequately relieved symptoms. We performed PubMed literature search with the word 'spondylolisthesis', and updated till September 18, 2016. We selected original research data involving surgical treatment of degenerative spondylolisthesis, and in total there were n articles, including data reported from Japan (n=37 series), South Korea (n=11 series), mainland China (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 single entry. We tried our best to filter out double/multiple reported data. Our results showed the median age of degenerative spondylolisthesis patients underwent surgical treatment was 66 years in Japan, 60 years in South Korea, 59 years in mainland China, 59 years in ROC (Taiwan), 65 years in USA, and 66 years in Europe. This study indicates Japan and South Korea may have different surgical practice pattern. It will be of interested to investigate whether more proportion of degenerative spondylolisthesis patients have been treated surgically in South Korea than in Japan. The cost-effectiveness of different approaches may warrant further analysis by professional spine surgeons. 
Zoltan Kaplar, Yi-Xiang J Wang
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