Degenerative Spondylolisthesis Accompanying LSS: Do We Need Fusion?

Degenerative Spondylolisthesis Accompanying LSS: Do We Need Fusion?

This study aimed to compare clinical results of decompression alone using minimal invasive unilateral laminotomy for bilateral decompression versus classical decompression and instrumentation and fusion.

The term "lumbar spinal stenosis" (LSS) describes the anatomical narrowing of the spinal canal, which occurs in older people because of spinal ageing.

Initial treatment is usually medical. Surgical management is recommended for patients with failed non-surgical trials. As claudication is always the main complain, lumbar canal decompression is the traditional surgical treatment.

Although adding instrumentation and fusion is not uncommon and widely used. In the literature, the benefit of fusion, is treating instability that causes degenerative spondylolisthesis, improve back pain if present, and avoid slippage progression, which possibly will occur with generous decompression and disruption of the posterior column.

Inclusion Criteria:

• Age > 50 years.
• Both sexes.
• Patients with symptoms of lumbar spinal stenosis (LSS) (neurogenic claudication) confirmed by magnetic resonance imaging (MRI), and a degenerative spondylolisthesis measuring at least 3 mm at the stenotic level on a plain X-ray.

Exclusion Criteria:

• Patients with excessive foraminal stenosis (a deformed nerve root in the intervertebral foramen).
• Thoracolumbar scoliosis of greater than 20 degrees.
• Patients with significant instability in plan radiography dynamic study.
• Patients who had previous spine surgery at lumbar region.