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Is lumbar fusion necessary in the treatment of degenerative spondylolisthesis?

Degenerative spondylolisthesis is a condition that requires surgical treatment in many cases.


About lumbar fusion

Lumbar fusion (also known as arthrodesis) is a surgical technique in which two or more of the vertebrae of the spine are joined/fused in such a way as to prevent movement between them.

In the past, fusion was performed in the following cases:

  • Progressive postoperative slips.
  • Younger patients.
  • Active patients with clear symptoms of instability.
  • If complete facetectomy had been performed.


Other surgical procedures

-Decompression surgery is basically done to release trapped nerves, in order to relieve pain, a small portion of the bone over the nerve root or disc material is removed from under the nerve root to give the nerve root more space. and provide a better healing environment. Radical decompression of L4 and L5 including both L4-5 facet complexes results in poor outcomes.

-In a laminectomy, the lamina (the bone at the back of the vertebra) is removed in one or more segments with the goal of reducing pressure on the spinal cord or nerves. Facetectomy is the resection of an articular facet, especially of the small intervertebral joints, in order to reduce a cervical vertebral dislocation or to perform a lumbar recalibration. It is worth mentioning that a wide laminectomy and medial facetectomy has better outcomes.

-Similar decompression with posterolateral autologous (derived from the same individual) fusion having better outcomes.

-Pseudoarthrosis (or nonunion is the failure of a bony union to take place) might occur in 9% of fused patients without instrumentation.


You might also want to read: Is reduction of spondylolisthesis necessary?



Most surgeons agree that decompression and fusion is the procedure of choice for most patients with degenerative spondylolisthesis with slip.

Fusion methods, however, vary amongst surgeons and best results are achieved when a surgeon has specialist skills in a particular technique and performs this technique regularly.

At Harley Street Hospital, we have some of the best specialists to diagnose and treat degenerative spondylolisthesis. Book an appointment to get a checkup.





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