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Decompression Versus Decompression Fusion in Lumbar Degenerative Stenosis/Spondylolisthesis
Katherine Dong1, Daniel Gelvez1, Nathan Redlich1
1Department of Orthopedic Surgery, Louisiana State University Health Sciences Center, 2021 Perdido Street, 7th floor, New Orleans, LA 70112, USA.
The Orthopedic Clinics of North America
|June 8, 2025
Summary
Degenerative spondylolisthesis and lumbar stenosis management involves nonoperative and operative options. Evidence conflicts on whether decompression alone or with fusion is superior, with minimally invasive surgery showing promise.
Area of Science:
- Orthopedics
- Neurosurgery
- Spinal Surgery
Background:
- Degenerative spondylolisthesis and lumbar stenosis are common spinal conditions.
- Management strategies range from conservative care to surgical interventions.
Purpose of the Study:
- To review the assessment and management of degenerative spondylolisthesis and lumbar stenosis.
- To evaluate clinical outcomes of surgical management and compare different surgical approaches.
Main Methods:
- Review of current literature on nonoperative and operative management.
- Analysis of evidence regarding isolated decompression versus decompression and fusion.
- Evaluation of minimally invasive techniques and their complications.
Main Results:
- Conflicting evidence exists regarding the superiority of isolated decompression versus decompression and fusion.
- Minimally invasive surgical techniques demonstrate potential for reduced complications compared to open decompression.
- Cost-effectiveness is an increasingly important factor in treatment decisions.
Conclusions:
- Optimal surgical strategy for degenerative spondylolisthesis and lumbar stenosis remains debated.
- Minimally invasive approaches may offer advantages in complication profiles.
- Healthcare cost considerations should influence treatment choices.
