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Operative Management of Degenerative Spondylolisthesis: A Critical Analysis Review

Decompressive surgical procedures for degenerative spondylolisthesis are supported by Level-II evidence demonstrating a sustained benefit compared with nonoperative care.Decompression and arthrodesis have a proven role for select cases of degenerative spondylolisthesis, but recent Level-I evidence comparing decompression alone with decompression and arthrodesis is conflicting with regard to the clinical benefit for stable grade-I or grade-II degenerative spondylolisthesis.The addition of segmental arthrodesis increases operative time, blood loss, length of stay, and hospital charges.Among patients undergoing arthrodesis, Level-I evidence supports inferior outcomes in patients with radiographic pseudarthrosis.A multitude of techniques exist to achieve segmental lumbar fusion; no strong evidence supports any single operative technique for providing superior clinical outcomes.