Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 10: Lumbar fusion for stenosis without spondylolisthesis

Update Item Information
Publication Type pre-print
School or College School of Medicine
Department Neurosurgery
Creator Dailey, Andrew T.
Other Author Resnick, Daniel K.; Watters III, William C.; Mummaneni, Praveen V.; Choudhri, Tanvir F.; Eck, Jason C.; Sharan, Alok; Groff, Michael W.; Wang, Jeffrey C.; Ghogawala, Zoher; Dhall, SanJay S.; Kaiser, Michael G.
Title Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 10: Lumbar fusion for stenosis without spondylolisthesis
Date 2014-01-01
Description Lumbar stenosis is one of the more common radiographic manifestations of the aging process, leading to narrowing of the spinal canal and foramen. When stenosis is clinically relevant, patients often describe activity-related low-back or lower-extremity pain, known as neurogenic claudication. For those patients who do not improve with conservative care, surgery is considered an appropriate treatment alternative. The primary objective of surgery is to reconstitute the spinal canal. The role of fusion, in the absence of a degenerative deformity, is uncertain. The previous guideline recommended against the inclusion of lumbar fusion in the absence of spinal instability or a likelihood of iatrogenic instability. Since the publication of the original guidelines, numerous studies have demonstrated the role of surgical decompression in this patient population; however, few have investigated the utility of fusion in patients without underlying instability. The majority of studies contain a heterogeneous cohort of subjects, often combining patients with and without spondylolisthesis who received various surgical interventions, limiting fusions to those patients with instability. It is difficult if not impossible, therefore, to formulate valid conclusions regarding the utility of fusion for patients with uncomplicated stenosis. Lower-level evidence exists, however, that does not demonstrate an added benefit of fusion for these patients; therefore, in the absence of deformity or instability, the inclusion of a fusion is not recommended.
Type Text
Publisher American Association of Neurological Surgeons
Volume 21
Issue 1
First Page 62
Last Page 66
Language eng
Bibliographic Citation Resnick, D. K., Watters III, W. C., Mummaneni, P. V., Dailey, A.T., Choudhri, T.F., Eck, J.C., Sharan, A., Groff, M. W., Wang, J. C., Ghogawala, Z., Dhall, S. S., & Kaiser, M. G. (2014). Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 10: Lumbar fusion for stenosis without spondylolisthesis. Journal of Neurosurgery: Spine, 21(1), 62-66.
Rights Management (c) American Association of Neurological Surgeons
Format Medium application/pdf
Format Extent 905,968 bytes
Identifier uspace,18814
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Reference URL https://collections.lib.utah.edu/ark:/87278/s6tb4h1k