AO spine clinical practice recommendations for the surgical management of degenerative spondylolisthesis: when to de compress alone and when to fuse
Study Design Literature review. Objective To provide a concise review of outcomes of decompression and fusion (D + F) vs decompression (D) alone for degenerative lumbar spondylolisthesis (DLS). Methods 6 articles were selected, including 3 randomized clinical trials (RCT), 2 meta-analyses, and 1 rad...
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
Sep 2025
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| In: |
Global spine journal
Year: 2025, Volume: 15, Issue: 7, Pages: 3046-3054 |
| ISSN: | 2192-5690 |
| DOI: | 10.1177/21925682251336755 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1177/21925682251336755
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| Author Notes: | Christopher T. Martin, MD, Luca Ambrosio, MD, Juan P. Cabrera, MD, Xiaolong Chen, MD, PhD, Jason P.Y. Cheung, MD, Waeel Hamouda, MD, Hai V. Le, MD, MPH, Philip K. Louie, MD, Sathish Muthu, MS, PhD, Hardeep Singh, MD, Mohamed A.R. Soliman, MD, Veranis Sotirios, MD, Javad Tavakoli, PhD, Sven Y. Vetter, MD, PhD, MBA, Zorica Buser, PhD, MBA, Andreas K. Demetriades, MD, Ashish Diwan, PhD, Patrick C. Hsieh, MD, Amit Jain, MD, MBA, Gianluca Vadalà, MD, PhD, Charles G. Fisher, MD, S. Tim Yoon, MD, PhD, and AO Spine Knowledge Forum Degenerative |
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| 245 | 1 | 0 | |a AO spine clinical practice recommendations for the surgical management of degenerative spondylolisthesis |b when to de compress alone and when to fuse |c Christopher T. Martin, MD, Luca Ambrosio, MD, Juan P. Cabrera, MD, Xiaolong Chen, MD, PhD, Jason P.Y. Cheung, MD, Waeel Hamouda, MD, Hai V. Le, MD, MPH, Philip K. Louie, MD, Sathish Muthu, MS, PhD, Hardeep Singh, MD, Mohamed A.R. Soliman, MD, Veranis Sotirios, MD, Javad Tavakoli, PhD, Sven Y. Vetter, MD, PhD, MBA, Zorica Buser, PhD, MBA, Andreas K. Demetriades, MD, Ashish Diwan, PhD, Patrick C. Hsieh, MD, Amit Jain, MD, MBA, Gianluca Vadalà, MD, PhD, Charles G. Fisher, MD, S. Tim Yoon, MD, PhD, and AO Spine Knowledge Forum Degenerative |
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| 520 | |a Study Design Literature review. Objective To provide a concise review of outcomes of decompression and fusion (D + F) vs decompression (D) alone for degenerative lumbar spondylolisthesis (DLS). Methods 6 articles were selected, including 3 randomized clinical trials (RCT), 2 meta-analyses, and 1 radiographic cohort study. Summarized factors affecting the outcomes of D + F vs D alone for DLS and provide expert level clinical recommendations. Results Ghogawala included DLS patients showing improved SF-36 scores (P = 0.046) and lower re-operation rates (P = 0.05) in D + F patients compared to D alone. Forsth, included patients with stenosis both with and without DLS, and showed no difference in any reported outcome measure or reoperation rate. Austevoll included DLS patients that found that D alone was non-inferior to D + F in the primary outcome measure of ODI reduction at 2-year after surgery. Gadjradi included studies showing higher morbidity in the D + F group, as compared to D alone. Shukla included studies which found there was no difference in the raw patient outcome scores at final follow-up. Blumenthal included DLS patients who received D and reported disc height of >6.5 mm, facet angle >50 degrees, and dynamic motion >1.25 mm were associated with high re-operation rates (45%, 39%, and 54% respectively). Conclusions The RCT's and meta-analyses report contradictory conclusions and no blanket statement regarding the efficacy of D + F vs D alone can be made for all patients with DLS. Surgeons should closely review pre-operative imaging for signs of instability in order to better identify appropriate patients for each indication. | ||
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