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Related Experiment Video

Updated: Oct 1, 2025

Author Spotlight: Scope of LE-ULBD as a Safe, Effective, and Minimally Invasive Approach to Treat Lumbar Spinal Stenosis
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Instrumented Versus Noninstrumented Spinal Fusion for Degenerative Lumbar Spondylolisthesis: A Systematic Review.

Takashi Hirase1,2, Jeremiah F Ling2, Varan Haghshenas1

  • 1Houston Methodist Orthopedic and Sports Medicine, Houston.

Clinical Spine Surgery
|March 3, 2022
PubMed
Summary

Instrumented posterolateral lumbar spine fusion shows higher fusion rates for degenerative lumbar spondylolisthesis compared to noninstrumented methods. However, both approaches yield similar functional improvements and complication rates.

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Area of Science:

  • Spine surgery
  • Orthopedics
  • Neurosurgery

Background:

  • Degenerative lumbar spondylolisthesis treatment is debated.
  • Optimal fusion technique for lumbar instability is unclear.
  • No comprehensive systematic review compares instrumented vs. noninstrumented posterolateral lumbar fusions.

Purpose of the Study:

  • Compare radiographic and clinical outcomes of instrumented versus noninstrumented posterolateral lumbar spine fusions.
  • Evaluate fusion rates, functional improvement, and complications in degenerative lumbar spondylolisthesis.

Main Methods:

  • Systematic review registered with PROSPERO, adhering to PRISMA guidelines.
  • Searched PubMed, SCOPUS, and Ovid MEDLINE for comparative studies (Level I-III).
  • Included studies on posterolateral lumbar fusions for degenerative lumbar spondylolisthesis.

Main Results:

  • Analyzed 7 studies with 672 patients (274 noninstrumented, 398 instrumented).
  • Instrumented fusion had higher solid fusion rates (87.6% vs. 77.1%) and lower pseudarthrosis rates (5.3% vs. 19.9%).
  • No significant differences in overall functional improvement, reoperation, or complication rates.

Conclusions:

  • Instrumented posterolateral fusion offers superior fusion rates for degenerative lumbar spondylolisthesis.
  • Functional outcomes, pain scores, and complication rates are comparable between instrumented and noninstrumented fusions.
  • The choice of fusion technique should consider these comparative outcomes.