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Updated: Feb 9, 2026
10:09
Transtubular Endoscopic Posterolateral Decompression for L5-S1 Lumbar Lateral Disc Herniation
Published on: October 14, 2022
4.5K
Comparison of Decompression, Decompression Plus Fusion, and Decompression Plus Stabilization for Degenerative
Hiroyuki Inose1, Tsuyoshi Kato1, Masato Yuasa1
1Department of Orthopaedics, Graduate School, Tokyo Medical and Dental University.
Clinical Spine Surgery
|June 8, 2018
Summary
For degenerative spondylolisthesis, decompression alone showed similar long-term results to adding fusion or stabilization. Instrumentation did not improve outcomes for low-grade cases.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Disorders
Background:
- Degenerative spondylolisthesis causes lumbar spinal stenosis due to neural structure compression.
- Treatment options include decompression, fusion, and stabilization, but optimal surgical approach remains debated.
- Limited prospective studies exist on the addition of instrumentation.
Purpose of the Study:
- To compare long-term clinical outcomes of decompression alone versus decompression with fusion or stabilization for degenerative spondylolisthesis.
- To evaluate the efficacy of surgical interventions for lumbar spinal stenosis.
Main Methods:
- Prospective, randomized controlled trial involving 85 patients with L4/L5 degenerative spondylolisthesis.
- Patients were assigned to decompression alone, decompression plus fusion, or decompression plus stabilization.
- Outcomes assessed using Japanese Orthopaedic Association and Visual Analogue Scale scores at 1 and 5 years.
Main Results:
- All groups showed significant postoperative improvement in clinical scores, maintained at 5 years.
- Fusion and stabilization groups had increased blood loss and operative time.
- The fusion group experienced a longer hospital stay; no significant differences in outcomes were found among groups at 1 or 5 years.
Conclusions:
- Additional instrumentation (fusion or stabilization) did not yield superior results compared to decompression alone for low-grade degenerative spondylolisthesis at 5-year follow-up.
- Decompression alone may be sufficient for selected patients with degenerative spondylolisthesis.
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