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Journal of Turkish Spinal Surgery, vol.35, no.3, pp.131-137, 2024 (Scopus)
Objective: To investigate the clinical and radiological outcomes of lumbar decompression and instrumented fusion without reduction in a cohort of female patients with degenerative spondylolisthesis. Materials and Methods: A retrospective analysis was conducted on 25 female patients who underwent posterior lumbar decompression and instrumented fusion at a single institution between January 2010 and January 2020, all of whom were followed up for at least 12 months. The study measured changes in pain and disability using the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI), along with changes in vertebral alignment, olisthesis, grade, and slip angle. Results: Significant reductions were observed in pain intensity (VAS scores decreased from 7.4 to 4.08, p<0.001) and disability levels (ODI scores reduced from 65.12 to 31.04, p<0.001). Improvements were also noted in the listhesis grade (from 2.08 to 1.28, p<0.001) and a decrease in sacral slope (p=0.017). The change in the slip angle was not statistically significant (p=0.074). No significant changes were observed in pelvic tilt (p=0.353). The only reported complication was adjacent segment degeneration in one patient, which required revision. Conclusion: In situ fusion without reduction can effectively alleviate pain, improve function, and lead to spontaneous correction of olisthesis grade in patients with degenerative lumbar spondylolisthesis, particularly those with low-grade slips. These outcomes support the efficacy of in situ fusion as a safer, less invasive alternative to vertebral reduction. This approach could influence clinical decision-making in the management of degenerative spondylolisthesis, although further studies with larger cohorts and extended follow-up are necessary to validate these findings.