Can patient factors identify who benefits from fusion?

Investigators found no clear advantage across 6 prespecified patient characteristics, with fusion associated with more perioperative complications.

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.

1