The study involved 80 fusion-treated patients and 60 decompression-treated patients. The two decompression techniques included a unilateral approach for bilateral decompression and a bilateral approach for contralateral decompression. The researchers compared results against the Japanese Orthopedic Association symptom score. The analysis took place over a 12-year timeframe.
Here are five observations:
1. The study found surgical indications for fusion decreased as time progressed; fusion was performed less often than decompression.
2. Fusion and decompression resulted in comparable decreases in clinical symptoms.
3. For those patients receiving decompression, "preoperative slip distance and instability, and postoperative slip progression or development of instability, did not correlate significantly with clinical outcome," according to the study abstract.
4. Of those patients with preoperative translation greater than or equal to 5 mm, eight out of 10 experienced slip progression, but no instability increases.
5. The researchers concluded, "decompression alone may be suitable even for patients with severe low back pain and translation [greater than or equal to] 5 mm," with excluded discogenic pain.
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