title: Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 9: fusion in patients with stenosis and spondylolisthesis.
abstract: The best medical evidence available in the literature confirms the utility of fusion for improving patient outcomes following decompression for stenosis associated with spondylolisthesis. The majority of evidence from other studies comparing outcomes after decompression alone or decompression combined with PLF in patients with stenosis and spondylolisthesis also favors the performance of PLF. The medical evidence regarding the use of pedicle screw fixation in this patient population is rated as Class III and is inconsistent. A consistent benefit associated with the use of pedicle screw fixation has been reported in patients with preoperative instability or kyphosis. Iatrogenic instability following decompression is associated with poor outcomes and may also be treated with PLF involving supplemental instrumentation. The precise definition of instability or kyphosis has varied among researchers and requires further study.
authors: Department of Neurosurgery, University of Wisconsin Medical School, Madison, Wisconsin 53792, USA. Resnick@neurosurg.wisc.edu
authors: Daniel K
authors: DK
authors: Resnick
authors: Tanvir F
authors: TF
authors: Choudhri
authors: Andrew T
authors: AT
authors: Dailey
authors: Michael W
authors: MW
authors: Groff
authors: Larry
authors: L
authors: Khoo
authors: Paul G
authors: PG
authors: Matz
authors: Praveen
authors: P
authors: Mummaneni
authors: William C
authors: WC
authors: Watters
authors: Jeffrey
authors: J
authors: Wang
authors: Beverly C
authors: BC
authors: Walters
authors: Mark N
authors: MN
authors: Hadley
mesh_terms: D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D013123:Spinal Fusion / Q000592:standards*; D013130:Spinal Stenosis / Q000601:surgery*; D013168:Spondylolisthesis / Q000601:surgery*