This 2014 narrative review by Eismont et al. surveys the full spectrum of surgical options for lumbar degenerative spondylolisthesis — from decompression alone to various fusion constructs and emerging minimally invasive techniques — synthesizing the evidence for each approach and addressing special populations including the elderly.
When selecting a fusion strategy for DS, know that instrumented posterolateral fusion is the standard of care and that choice of fusion technique (PLF vs. TLIF vs. 360°) does not clearly drive 4-year outcomes — reserve interbody fusion for patients with instability, local kyphosis, or high nonunion risk, and counsel patients that surgical benefit over conservative care is durable to at least 4 years.
This 2014 narrative review by Eismont et al. surveys the full spectrum of surgical options for lumbar degenerative spondylolisthesis — from decompression alone to various fusion constructs and emerging minimally invasive techniques — synthesizing the evidence for each approach and addressing special populations including the elderly.
When selecting a fusion strategy for DS, know that instrumented posterolateral fusion is the standard of care and that choice of fusion technique (PLF vs. TLIF vs. 360°) does not clearly drive 4-year outcomes — reserve interbody fusion for patients with instability, local kyphosis, or high nonunion risk, and counsel patients that surgical benefit over conservative care is durable to at least 4 years.