Evidence-Based Guidelines for the Surgical Management of Degenerative Lumbar Spondylolisthesis

These evidence-based guidelines reflect the evolving surgical management of degenerative lumbar spondylolisthesis, grounded in high-quality data that help clarify longstanding topics of contention. Key topics discussed include operative versus nonoperative management, decompression alone versus decompression with fusion, instrumented versus noninstrumented fusion, fusion with reduction versus fusion in situ, minimally invasive and endoscopic surgery, the use of interbody devices and biologics for fusion, robot-assisted surgery, intraoperative CT-based navigation, single-position surgery, enhanced recovery after surgery protocols, and lumbar facet arthroplasty. These guidelines support evidence-based surgical decision-making and the integration of research advancements into modern spine surgery practice.