{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:56:13Z","timestamp":1785372973724,"version":"3.55.0"},"reference-count":13,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The ideal surgical management of grade I lumbar spondylolisthesis has not been determined despite extensive prior investigations. In this cohort study, the authors used data from the large, multicenter, prospectively collected Quality Outcomes Database to bridge the gap between the findings in previous randomized trials and those in a more heterogeneous population treated in a typical practice. The objective was to assess the difference in patient-reported outcomes among patients undergoing decompression alone or decompression plus fusion.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The primary outcome measure was change in 24-month Oswestry Disability Index (ODI) scores. The minimal clinically important difference (MCID) in ODI score change and 30% change in ODI score at 24 months were also evaluated. After adjusting for patient-specific and clinical factors, multivariable linear and logistic regressions were employed to evaluate the impact of fusion on outcomes. To account for differences in age, sex, body mass index, and baseline listhesis, a sensitivity analysis was performed using propensity score analysis to match patients undergoing decompression only with those undergoing decompression and fusion.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>In total, 608 patients who had grade I lumbar spondylolisthesis were identified (85.5% with at least 24 months of follow-up); 140 (23.0%) underwent decompression alone and 468 (77.0%) underwent decompression and fusion. The 24-month change in ODI score was significantly greater in the fusion plus decompression group than in the decompression-only group (\u221225.8 \u00b1 20.0 vs \u221215.2 \u00b1 19.8, p &lt; 0.001). Fusion remained independently associated with 24-month ODI score change (B = \u22127.05, 95% CI \u221210.70 to \u22123.39, p \u2264 0.001) in multivariable regression analysis, as well as with achieving the MCID for the ODI score (OR 1.767, 95% CI 1.058\u20132.944, p = 0.029) and 30% change in ODI score (OR 2.371, 95% CI 1.286\u20134.371, p = 0.005). Propensity score analysis resulted in 94 patients in the decompression-only group matched 1 to 1 with 94 patients in the fusion group. The addition of fusion to decompression remained a significant predictor of 24-month change in the ODI score (B = 2.796, 95% CI 2.228\u201313.275, p = 0.006) and of achieving the 24-month MCID ODI score (OR 2.898, 95% CI 1.214\u20136.914, p = 0.016) and 24-month 30% change in ODI score (OR 2.300, 95% CI 1.014\u20135.216, p = 0.046).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>These results suggest that decompression plus fusion in patients with grade I lumbar spondylolisthesis may be associated with superior outcomes at 24 months compared with decompression alone, both in reduction of disability and in achieving clinically meaningful improvement. Longer-term follow-up is warranted to assess whether this effect is sustained.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2020.9.spine201082","type":"journal-article","created":{"date-parts":[[2021,4,16]],"date-time":"2021-04-16T08:36:55Z","timestamp":1618562215000},"page":"42-51","source":"Crossref","is-referenced-by-count":30,"title":["Patient-reported outcome improvements at 24-month follow-up after fusion added to decompression for grade I degenerative lumbar spondylolisthesis: a multicenter study using the Quality Outcomes Database"],"prefix":"10.3171","volume":"35","author":[{"given":"Erica F","family":"Bisson","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Bydon","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed A","family":"Alvi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anshit","family":"Goyal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven D","family":"Glassman","sequence":"additional","affiliation":[{"name":"Norton Leatherman Spine Center, Louisville, Kentucky;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin T","family":"Foley","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Tennessee, Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric A","family":"Potts","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Indiana University, Goodman Campbell Brain and Spine, Indianapolis, Indiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher I","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and Orthopaedic Surgery, Duke University, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark E","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domagoj","family":"Coric","sequence":"additional","affiliation":[{"name":"Neuroscience Institute, Carolinas Healthcare System and Carolina Neurosurgery & Spine Associates, Charlotte, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J","family":"Knightly","sequence":"additional","affiliation":[{"name":"Atlantic Neurosurgical Specialists, Morristown, New Jersey;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Y","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Miami, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai-Ming","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Weill Cornell Medical Center, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan R","family":"Slotkin","sequence":"additional","affiliation":[{"name":"Geisinger Health, Danville, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony L","family":"Asher","sequence":"additional","affiliation":[{"name":"Neuroscience Institute, Carolinas Healthcare System and Carolina Neurosurgery & Spine Associates, Charlotte, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S","family":"Virk","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Weill Cornell Medical Center, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew Y","family":"Yew","sequence":"additional","affiliation":[{"name":"Lahey Clinic, Burlington, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regis W","family":"Haid","sequence":"additional","affiliation":[{"name":"Atlanta Brain and Spine Care, Atlanta, Georgia; 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