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Seven patients (6%) developed lumbar instability, three patients (2%) developed new stenosis at an adjacent unoperated level, and three patients (2%) developed a new disc herniation between 2 and 5 years after surgery. Progressive postoperative spondylolisthesis occurred in 31% of patients with normal preoperative alignment (mean 7.8 mm, range 2\u201320 mm) and in 73% of patients with preoperative subluxation (mean 5.1 mm, range 2\u201313 mm) in whom fusion was not attained. 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