Degenerative spondylolisthesis: when to fuse?

Abstract

This article reviews four reports that have addressed the efficacy of spinal instrumentation to enhance spinal fusion in patients with degenerative spondylolisthesis. These papers serve to highlight some of the common problems with interpreting and applying the clinical findings of such studies: small, nonuniform patient selection; variable instrumentation techniques; relatively brief follow-up periods (usually less than 5 years); lack of a uniform scale for clinical assessment of patients; and lack of consensus on the definition and clinical documentation of motion segment instability.