Question special
Lead Moderator

Thank you to all of the authors and experts for a great start to this discussion!

There has been discussion of patient selection—of identifying patient subtypes for whom decompression with fusion would be more beneficial. Dr. Försth and colleagues stratified patients by degree of spondylisthesis and observed no difference between fusion and non-fusion in the cohort with greatest degree of slip (>7 mm). However, the SSSS did not utilize dynamic imaging (e.g. flexion-extension films) to delineate and study the degree of functional stability. Dr. Ghogawala and colleagues utilized flexion-extension films to exclude patients with gross instability from SLIP (presumably proceeding directly to fusion).

I was wondering if the authors and experts could weigh in on the concept of stability? How can we currently assess stability in a standardized way and do we have data to support use of fusion and decompression in these patients?