ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2012
To fuse or not to fuse in lumbar degenerative spondylolisthesis: do baseline symptoms help provide the answer?
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
40 citing papers in PubMed, 7 syntheses or guidelines pooled it, 92 citations in OpenAlex.
- Decompression, decompression plus fusion and decompression plus dynamic stabilization for degenerative lumbar spondylolisthesis: a network meta-analysis.Journal of orthopaedic surgery and research · 2025Pooled it
- Decompression with interbody fusion versus decompression alone for degenerative lumbar diseases: A meta-analysis.PloS one · 2025Pooled it
- Decompression with fusion versus decompression in the treatment of lumbar spinal stenosis: A systematic review and meta-analysis.Medicine · 2020Pooled it
- Pooled it
- Decompression with or without concomitant fusion in lumbar stenosis due to degenerative spondylolisthesis: a systematic review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2018Pooled it
- Decompression plus fusion versus decompression alone for degenerative lumbar spondylolisthesis: a systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2017Pooled it
- Surgery for adult spondylolisthesis: a systematic review of the evidence.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2016Pooled it
- Preoperative multifidus activation during movement and low back pain worsening after lumbar spinal stenosis surgery: a prospective observational study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- The Core Outcome Measures Index (COMI) comes of age: 18 years of efficient and effective patient-reported outcome measurement in the field of spinal disorders. Part 1. Development of the COMI, interpretation of scores, and use in research.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Review
- A narrative review and scoring proposal for secondary lumbar instability after lumbar decompression surgery.Acta neurochirurgica · 2025Review
- Mapping healthcare services and practice variations in spinal care across countries: The Spine Atlas Initiative.Brain & spine · 2025Article
- Optimization of radiation doses for open lumbar spinal fusion using C-arm fluoroscopy and impact on radiation-induced cancer: a pilot study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Article
- Evaluation of differences in expression pattern of three isoforms of the transforming growth factor beta in patients with lumbosacral stenosis.Cell cycle (Georgetown, Tex.) · 2024Article
- Symptomatic lumbar stenosis due to low-grade degenerative spondylolisthesis can effectively be treated with mere decompression.Acta neurochirurgica · 2023Article
- Comparison between Decompression Alone and with Additional Fusion for Degenerative Lumbar Spondylolisthesis: A Systematic Review and Meta-Analysis.Spine surgery and related research · 2023Article
- Surgical outcomes between posterior decompression alone and posterior decompression with fusion surgery among patients with Meyerding grade 2 degenerative spondylolisthesis: a multicenter cohort study.BMC musculoskeletal disorders · 2022Article
- Decompression alone or decompression and fusion in degenerative lumbar spondylolisthesis.EClinicalMedicine · 2022Article
- Degenerative Grade 3 Spondylolisthesis Management: A Case Report and Literature Review.Cureus · 2022Article
- Effectiveness and safety of decompression alone versus decompression plus fusion for lumbar spinal stenosis with degenerative spondylolisthesis: a systematic review and meta-analysis.Annals of translational medicine · 2022Article
- Do preoperative clinical and radiographic characteristics impact patient outcomes following one-level minimally invasive transforaminal lumbar interbody fusion based upon presenting symptoms?The spine journal : official journal of the North American Spine Society · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionClinical symptoms in lumbar degenerative spondylolisthesis (LDS) vary from predominantly radiating pain to severe mechanical low back pain. We examined whether the outcome of surgery for LDS varied depending on the predominant baseline symptom and the treatment administered [decompression with fusion (D&F) or decompression alone (D)].
methods213 consecutive patients (69 ± 9 years; 155f, 58 m) participated. Inclusion criteria were LDS, maximum three affected levels, no previous surgery at the affected level, and D (N = 56) or D&F (N = 157) as the operative procedure. Pre-op and at 12 months' follow-up (FU), patients completed the multidimensional Core Outcome Measures Index (COMI) including 0-10 leg-pain (LP) and LBP scales. At 12 months' FU, patients rated global outcome which was then dichotomised into "good" and "poor".
resultsPre-operatively, LBP and COMI scores were significantly worse (p < 0.05) in the D&F group than in the D group. The improvement in COMI at 12 months' FU was significantly greater for D&F than for D (p < 0.001) and was not influenced by the patient's declared "main problem" at baseline (back pain, leg pain, or neurological disturbances) (p > 0.05). There was a higher proportion (p = 0.01) of "good" outcomes at 12 months' FU in D&F (86%) than in D (70%). Multiple regression analysis, controlling for possible confounders, revealed treatment group to be the only significant predictor of outcome (adding fusion = better outcome). DISCUSSION: Our study indicated that LDS patients showed better patient-based outcome with instrumented fusion and decompression than with decompression alone, regardless of baseline symptoms. This may be due to the fact that the underlying slippage as the cause of the stenosis is better addressed with fusion.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.