What to consider in degenerative spondylolisthesis: posterolateral fusion or transforaminal interbody fusion

Degenerative spondylolisthesis (DS) usually happens at lower lumbar levels (more commonly at L4–5) with the degree of slip is Meyerding classification type 1 or 2. Rarely DS has Meyerding type 3 or more slip. DS is usually a combination of facet hypertrophy and thickening of ligamentum flavum that leads to spinal stenosis. Therefore, majority of DS patients usually presents to a surgeon with symptoms of spinal stenosis. In that sense, the treatment for DS is hotly debated in literature. Different articles clearly mention superiority of decompression and fixation (DF) over decompression alone (D) in such cases (1). Decompression alone can improve clinical symptoms of patients with DS; however, symptoms can recur in few years requiring another surgery. Therefore, according to the current consensus, DF is often indicated while treating DS with lumbar stenosis (2-4).