SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2023
Decompression alone versus decompression with fusion in patients with lumbar spinal stenosis with degenerative spondylolisthesis: a systematic review and meta-analysis.
Synthesis 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, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
50 citing papers in PubMed, 4 syntheses or guidelines pooled it, 62 citations in OpenAlex.
- Decompression alone versus decompression with fusion in the treatment of lumbar degenerative spondylolisthesis: evaluating the overlapping meta-analyses.Neurosurgical review · 2026Pooled it
- Minimally invasive tubular decompression versus traditional open surgery for lumbar spinal stenosis: a systematic review and meta-analysis.Scientific reports · 2025Pooled it
- Summary of the best evidence for early mobilization after lumbar spinal fusion surgery: a systematic review.BMC surgery · 2025Pooled it
- Decompression with interbody fusion versus decompression alone for degenerative lumbar diseases: A meta-analysis.PloS one · 2025Pooled it
- Use of an Expert Panel for Symptomatic Patients With Grade I Degenerative Lumbar Spondylolisthesis: A Randomized Clinical Trial.Neurosurgery · 2026Trial
- Surgeon Recommendation and Outcomes of Decompression With vs Without Fusion in Patients With Degenerative Spondylolisthesis.JAMA network open · 2025Trial
- Article
- Full-Endoscopic Unilateral Laminotomy for Bilateral Decompression Under Surgeon-Directed Local Anesthesia in Older Patients with Lumbar Spinal Stenosis.Medicina (Kaunas, Lithuania) · 2026Article
- Endoscopic decompression alone for lumbar spinal stenosis with degenerative spondylolisthesis: a systematic review and meta-analysis of paired change scores.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 · 2026Review
- Long-term clinical and radiographic outcomes of interlaminar coflex dynamic stabilization versus posterior lumbar interbody fusion for lumbar spinal stenosis: a comparative study with minimum 15-year follow-up.Journal of orthopaedic surgery and research · 2026Article
- A summer reflection.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
- Elective Lumbar Decompression With Fusion Is Associated With Increased Mortality Compared With Decompression Alone: A National Propensity-Matched Analysis of Aging Cohorts.Global spine journal · 2026Article
- Unilateral biportal endoscopic lumbar interbody fusion: Radiographic and clinical outcomes in grade I lumbar spondylolisthesis.Medicine · 2026Article
- Biomechanical effects of endoscopic ULBD in a reduced‑stiffness lumbar spine model: focus on endplate stress and hypothesis‑generating risk indicators (a finite element analysis).Scientific reports · 2026Article
- Interlaminar versus sublaminar lumbar decompression: a retrospective study on patient satisfaction as measured by PROMIS outcomes.Journal of spine surgery (Hong Kong) · 2026Article
- Comparison between large interbody cage versus two smaller interbody cages in unilateral biportal endoscopic transforaminal interbody fusion.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
- Radiological Outcomes of PEEK Versus Rigid Rod Stabilization in Lumbar Spinal Stenosis Surgery: The Role of Preoperative and Postoperative Findings in Adjacent Segment Disease.Diagnostics (Basel, Switzerland) · 2026Article
- Reliability of functional imaging in assessing instability of lumbar degenerative spondylolisthesis.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
- Full-endoscopic Laminotomy Is Effective for Lumbar Spinal Stenosis with Low-grade Spondylolisthesis: A Comparative Cohort Study.Neurologia medico-chirurgica · 2026Article
- Robot-assisted unilateral biportal endoscopic lumbar interbody fusion for lumbar spondylolisthesis: ipsilateral direct with contralateral indirect decompression.BMC musculoskeletal disorders · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSurgical decompression is standard care in the treatment of degenerative spondylolisthesis in patients with symptomatic lumbar spinal stenosis, but there remains controversy over the benefits of adding fusion. The persistent lack of consensus on this matter and the availability of new data warrants a contemporary systematic review and meta-analysis of the literature.
methodsMultiple online databases were systematically searched up to October 2022 for randomized controlled trials (RCTs) and prospective studies comparing outcomes of decompression alone versus decompression with fusion for lumbar spinal stenosis in patients with degenerative spondylolisthesis. Primary outcome was the Oswestry Disability Index. Secondary outcomes included leg and back pain, surgical outcomes, and radiological outcomes. Pooled effect estimates were calculated and presented as mean differences (MD) with their 95% confidence intervals (CI) at two-year follow-up.
resultsOf the identified 2403 studies, eventually five RCTs and two prospective studies were included. Overall, most studies had a low or unclear risk of selection bias and most studies were focused on low grade degenerative spondylolisthesis. All patient-reported outcomes showed low statistical heterogeneity. Overall, there was high-quality evidence suggesting no difference in functionality at two years of follow-up (MD - 0.31, 95% CI - 3.81 to 3.19). Furthermore, there was high-quality evidence of no difference in leg pain (MD - 1.79, 95% CI - 5.08 to 1.50) or back pain (MD - 2.54, 95% CI - 6.76 to 1.67) between patients undergoing decompression vs. decompression with fusion. Pooled surgical outcomes showed less blood loss after decompression only, shorter length of hospital stay, and a similar reoperation rate compared to decompression with fusion.
conclusionBased on the current literature, there is high-quality evidence of no difference in functionality after decompression alone compared to decompression with fusion in patients with degenerative lumbar spondylolisthesis at 2 years of follow-up. Further studies should focus on long-term comparative outcomes, health economic evaluations, and identifying those patients that may benefit more from decompression with fusion instead of decompression alone. This review was registered at Prospero (CRD42021291603).
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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.