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Degenerative spondylolisthesis: contemporary review of the role of interbody fusion

  • General Review • SPINE - LUMBAR
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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Degenerative spondylolisthesis is a common presentation, yet the best surgical treatment continues to be a matter of debate. Interbody fusion is one of a number of options, but its exact role remains ill defined. The aim of this study was to provide a contemporary review of the literature to help determine the role, if any, of interbody fusion in the surgical treatment of degenerative spondylolisthesis. A systematic review of the literature since 2005 was performed. Details on study size, patient age, surgical treatments, levels of slip, patient reported outcome measures, radiographic outcomes, complications and selected utility measures were recorded. Studies that compared a cohort treated with interbody fusion and at least one other surgical intervention for comparison were included for review. Only studies examining the effect in degenerative spondylolisthesis were included. Two authors independently reviewed the manuscripts and extracted key data. Thirteen studies were included in the final analysis. A total of 565 underwent interbody fusion and 761 underwent other procedures including decompression alone, interspinous stabilisation and posterolateral fusion with or without instrumentation. Most studies were graded Level III evidence. Heterogeneous reporting of outcomes prevented formal statistical analysis. However, in general, studies reviewed concluded no significant clinical or radiographic difference in outcome between interbody fusion and other treatments. Two small studies suggested interbody fusion is a better option in cases of definite instability. Interbody fusion only provided outcomes as good as instrumented posterolateral fusion. However, most studies were Level III, and hence, we remain limited in defining the exact role of interbody fusion—cases with clear instability appear to be most appropriate. Future work should use agreed-upon common outcome measures and definitions.

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Acknowledgements

Joseph Baker received the Joint RCSI/Gussie Mehigan Scholarship in support of Fellowship training.

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Authors and Affiliations

  1. Department of Spine and Spinal Deformity Surgery, NYU Langone Medical Center Hospital for Joint Diseases, 301 East 17th Street, New York, NY, 10002, USA

    Joseph F. Baker, Thomas J. Errico, Yong Kim & Afshin Razi

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  1. Joseph F. Baker
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  2. Thomas J. Errico
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Correspondence to Joseph F. Baker.

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Dr. Baker reports personal fees from 3D4Medical, outside the submitted work; Dr. Errico reports other from K2 M, outside the submitted work; and Dr. Kim and Dr. Razi have nothing to disclose.

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Baker, J.F., Errico, T.J., Kim, Y. et al. Degenerative spondylolisthesis: contemporary review of the role of interbody fusion. Eur J Orthop Surg Traumatol 27, 169–180 (2017). https://doi.org/10.1007/s00590-016-1885-5

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