SynthesisJournal of neurology, neurosurgery, and psychiatry2023
Decompression alone versus decompression with instrumented fusion in the treatment of lumbar degenerative spondylolisthesis: a systematic review and meta-analysis of randomised trials.
Synthesis in Journal of neurology, neurosurgery, and psychiatry, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Decompression alone versus decompression with fusion in the treatment of lumbar degenerative spondylolisthesis: evaluating the overlapping meta-analyses.Neurosurgical review · 2026Pooled it
- Decompression with interbody fusion versus decompression alone for degenerative lumbar diseases: A meta-analysis.PloS one · 2025Pooled it
- Use of an Expert Panel for Symptomatic Patients With Grade I Degenerative Lumbar Spondylolisthesis: A Randomized Clinical Trial.Neurosurgery · 2026Trial
- Surgeon Recommendation and Outcomes of Decompression With vs Without Fusion in Patients With Degenerative Spondylolisthesis.JAMA network open · 2025Trial
- Elective Lumbar Decompression With Fusion Is Associated With Increased Mortality Compared With Decompression Alone: A National Propensity-Matched Analysis of Aging Cohorts.Global spine journal · 2026Article
- Review
- Novel 360° lumbar arthroplasty: Surgical technique and procedural details.North American Spine Society journal · 2026Article
- Radiographic phenotype-driven clustering in lumbar decompression: comparative study of outcome and reoperation risk.The spine journal : official journal of the North American Spine Society · 2026Article
- Radiographic and clinical outcomes at 12 months following full endoscopic interlaminar decompression for grade 1 degenerative lumbar spondylolisthesis.Scientific reports · 2025Article
- Identifying preoperative radiographic metrics to guide surgical selection in lumbar spondylolisthesis and stenosis.North American Spine Society journal · 2025Article
- Decompression only versus decompression plus fusion for spinal canal stenosis of adjacent segment during primary single-segment lumbar fusion surgery.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Comparable long-term pain and disability outcomes following decompression alone versus decompression with fusion in lumbar spinal stenosis patients with high-signal facet joints.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Uniportal endoscopic decompression without fusion for grade II-III degenerative spondylolisthesis in the elderly: a case series.Journal of surgical case reports · 2025Article
- Advancements in Spinal Endoscopic Surgery: Comprehensive Techniques and Pathologies Addressed by Full Endoscopy Beyond Lumbar Disc Herniation.Journal of clinical medicine · 2025Review
- Evaluating surgical interventions for low-grade degenerative lumbar spondylolisthesis: a network meta-analysis of decompression alone, fusion, and dynamic stabilization.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Mapping healthcare services and practice variations in spinal care across countries: The Spine Atlas Initiative.Brain & spine · 2025Article
- Decompression alone or with fusion for degenerative lumbar spondylolisthesis (Nordsten-DS): five year follow-up of a randomised, multicentre, non-inferiority trial.BMJ (Clinical research ed.) · 2024Article
- Clinical and radiological outcomes of lumbar endoscopic decompression for treating lumbar spinal stenosis and degenerative lumbar scoliosis: a retrospective study at mean 4.4 years follow-up.Frontiers in surgery · 2024Article
- Full-endoscopic foraminotomy in low-grade degenerative and isthmic spondylolisthesis: a patient-specific tailored approach.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the efficacy of adding instrumented spinal fusion to decompression to treat degenerative spondylolisthesis (DS).
designSystematic review with meta-analysis. DATA SOURCES: MEDLINE, Embase, Emcare, Cochrane Library, CINAHL, Scopus, ProQuest Dissertations & Theses Global, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform from inception to May 2022. ELIGIBILITY CRITERIA FOR STUDY SELECTION: Randomised controlled trials (RCTs) comparing decompression with instrumented fusion to decompression alone in patients with DS. Two reviewers independently screened the studies, assessed the risk of bias and extracted data. We provide the Grading of Recommendations, Assessment, Development and Evaluation assessment of the certainty of evidence (COE).
resultsWe identified 4514 records and included four trials with 523 participants. At a 2-year follow-up, adding fusion to decompression likely results in trivial difference in the Oswestry Disability Index (range 0-100, with higher values indicating greater impairment) with mean difference (MD) 0.86 (95% CI -4.53 to 6.26; moderate COE). Similar results were observed for back and leg pain measured on a scale of 0 to 100, with higher values indicating more severe pain. There was a slightly increased improvement in back pain (2-year follow-up) in the group without fusion shown by MD -5·92 points (95% CI -11.00 to -0.84; moderate COE). There was a trivial difference in leg pain between the groups, slightly favouring the one without fusion, with MD -1.25 points (95% CI -6.71 to 4.21; moderate COE). Our findings at 2-year follow-up suggest that omitting fusion may increase the reoperation rate slightly (OR 1.23; 0.70 to 2.17; low COE).
conclusionsEvidence suggests no benefits of adding instrumented fusion to decompression for treating DS. Isolated decompression seems sufficient for most patients. Further RCTs assessing spondylolisthesis stability are needed to determine which patients would benefit from fusion. PROSPERO REGISTRATION NUMBER: CRD42022308267.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.