Five current trends in degenerative spondylolisthesis treatment:
1. Simple decompression or indirect decompression may be appropriate in cases of symptomatic degenerative spondylolisthesis.
2. Some cases are more complex, and patients differ in terms of overall health and sagittal alignment. The authors advise against performing decompression without fusion in cases of instability, significant disc height and large bone resection for decompression.
3. Instrumented fusion is the standard of care.
4. Surgeons can add interbody fusion to the posterolateral arthrodesis to improve graft area and stability, increase local lordosis and open foramina.
5. Radicular decompression may be necessary. Surgeons can perform it indirectly through interbody fusion or interspinous spacer, but the most common technique is posterior decompression with fusion.
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