Fusion Is the Optimal Treatment of Lumbar Spondylolisthesis: The Modified Minimally Invasive Interbody Selection Algorithm.

Lumbar spondylolisthesis is a leading cause of low back pain, with degenerative and isthmic subtypes most commonly affecting L4-5 and L5-S1, respectively. While both decompression alone and decompression with fusion are viable surgical options for symptomatic lumbar spondylolisthesis, growing evidence, particularly from the SpineCORe study group's Quality Outcomes Database analysis and the SLIP trial, supports fusion as the preferred treatment in North American populations. Multiple established fusion techniques are available, including posterolateral fusion and minimally invasive interbody approaches (anterior lumbar interbody fusion, lateral lumbar interbody fusion, and transforaminal lumbar interbody fusion).