Management of Single Level Lumbar Degenerative Spondylolisthesis:Decompression Alone or Decompression and Fusion

Background: Degenerative spondylolisthesis is the second common form ofspondylolisthesis, it typically occurs at the level of L4-L5. Patients present withintermittent low back pain, neurogenic claudication, and occasionally radicular pain.Only 10% to 15% of patients may need surgery. Surgical options include spinaldecompression alone, or decompression with fusion. Objective: This study is comparingthe results of decompression alone and decompression with fusion for degenerativespondylolisthesis. Patients Methods: Sixty patients with degenerative spondylolisthesiswere included in this study. All cases failed to respond to conservative measures for atleast three months. Patients were randomly divided in two groups, Group (A) patientswere operated upon by decompression and posterolateral instrumental fusion, whileGroup (B) patients were operated upon by decompression alone. Results: Fifty seven ofour cases (95%) showed improvement, regarding their clinical symptoms, 5% of casesdidn’t show any improvement. None of our cases showed deterioration than theirpreoperative state. No statistical significance was found between recovery rates in bothgroups. There was no statistical significance between complication rates of both groups.The hospital stay was significantly shorter in the non-fusion group than the fusion group.Conclusion: Degenerative spondylolisthesis is more commonly seen in females in their 5thand 6th decades. It affects commonly L4/5 and L5/S1 spaces. There was no statisticalsignificant difference when comparing the recovery rates of decompression alone, anddecompression followed by fusion. The incidence of complications was the same in bothgroups. The only significant difference in this study was a longer hospital stay in thefusion group in comparison to the non fusion one.