5 Key Takeaways

• 1

  This cohort study included 2,252 patients with degenerative lumbar spondylolisthesis treated with decompression alone or decompression with fusion.

• 2

  At 12 months, the study found no clear differences between procedures in disability, pain, quality of life, treatment satisfaction, or subsequent spine surgery.

• 3

  Prespecified patient characteristics, including age, sex, smoking status, BMI, back pain intensity, and ASA grade, did not clearly modify comparative treatment effects.

• 4

  Decompression alone was associated with fewer perioperative complications, operations about 85 minutes shorter, and hospital stays 1.9 days shorter than fusion.

• 5

  An exploratory post hoc analysis found worse disability outcomes with fusion among men with BMI of at least 30 kg/m², a finding requiring further investigation.