Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 9: Lumbar fusion for stenosis with spondylolisthesis

Daniel K. Resnick, William C. Watters, Alok Sharan, Praveen V. Mummaneni, Andrew T. Dailey, Jeffrey C. Wang, Tanvir F. Choudhri, Jason Eck, Zoher Ghogawala, Michael W. Groff, Sanjay S. Dhall, Michael G. Kaiser

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Patients presenting with stenosis associated with a spondylolisthesis will often describe signs and symptoms consistent with neurogenic claudication, radiculopathy, and/or low-back pain. The primary objective of surgery, when deemed appropriate, is to decompress the neural elements. As a result of the decompression, the inherent instability associated with the spondylolisthesis may progress and lead to further misalignment that results in pain or recurrence of neurological complaints. Under these circumstances, lumbar fusion is considered appropriate to stabilize the spine and prevent delayed deterioration. Since publication of the original guidelines there have been a significant number of studies published that continue to support the utility of lumbar fusion for patients presenting with stenosis and spondylolisthesis. Several recently published trials, including the Spine Patient Outcomes Research Trial, are among the largest prospective randomized investigations of this issue. Despite limitations of study design or execution, these trials have consistently demonstrated superior outcomes when patients undergo surgery, with the majority undergoing some type of lumbar fusion procedure. There is insufficient evidence, however, to recommend a standard approach to achieve a solid arthrodesis. When formulating the most appropriate surgical strategy, it is recommended that an individualized approach be adopted, one that takes into consideration the patient's unique anatomical constraints and desires, as well as surgeon's experience.

Original languageEnglish (US)
Pages (from-to)54-61
Number of pages8
JournalJournal of Neurosurgery: Spine
Volume21
Issue number1
DOIs
StatePublished - 2014

Fingerprint

Spondylolisthesis
Pathologic Constriction
Spine
Guidelines
Radiculopathy
Arthrodesis
Low Back Pain
Decompression
Signs and Symptoms
Publications
Outcome Assessment (Health Care)
Recurrence
Pain

Keywords

  • Fusion
  • Lumbar spine
  • Practice guidelines
  • Spondylolisthesis
  • Stenosis

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Neurology

Cite this

Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 9 : Lumbar fusion for stenosis with spondylolisthesis. / Resnick, Daniel K.; Watters, William C.; Sharan, Alok; Mummaneni, Praveen V.; Dailey, Andrew T.; Wang, Jeffrey C.; Choudhri, Tanvir F.; Eck, Jason; Ghogawala, Zoher; Groff, Michael W.; Dhall, Sanjay S.; Kaiser, Michael G.

In: Journal of Neurosurgery: Spine, Vol. 21, No. 1, 2014, p. 54-61.

Research output: Contribution to journalArticle

Resnick, DK, Watters, WC, Sharan, A, Mummaneni, PV, Dailey, AT, Wang, JC, Choudhri, TF, Eck, J, Ghogawala, Z, Groff, MW, Dhall, SS & Kaiser, MG 2014, 'Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 9: Lumbar fusion for stenosis with spondylolisthesis', Journal of Neurosurgery: Spine, vol. 21, no. 1, pp. 54-61. https://doi.org/10.3171/2014.4.SPINE14274
Resnick, Daniel K. ; Watters, William C. ; Sharan, Alok ; Mummaneni, Praveen V. ; Dailey, Andrew T. ; Wang, Jeffrey C. ; Choudhri, Tanvir F. ; Eck, Jason ; Ghogawala, Zoher ; Groff, Michael W. ; Dhall, Sanjay S. ; Kaiser, Michael G. / Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 9 : Lumbar fusion for stenosis with spondylolisthesis. In: Journal of Neurosurgery: Spine. 2014 ; Vol. 21, No. 1. pp. 54-61.
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