Fusion for Lumbar Spinal Stenosis — Safeguard or Superfluous Surgical Implant?

Lumbar spinal stenosis is typically caused by degenerative facet-joint arthrosis and leads to compression of the nerves, resulting in walking disability and leg pain in the elderly. The use of surgical decompression alone to treat lumbar spinal stenosis declined slightly in the United States between 2002 and 2007, whereas the use of a combined procedure of decompression and fusion increased by a factor of 15 during this period.1 Evidence showing a benefit of adding fusion to decompression surgery is lacking, even in the subgroup of patients who have degenerative spondylolisthesis (a slip of adjacent vertebrae caused by facet-joint arthrosis).2, . . .