Surgical Treatment of Lumbar Spondylolisthesis in the Elderly

By 2060, population projections estimate the number of individuals older than 65 will double. Prevalence of degenerative spondylolisthesis is reported as 4.1%11.1% within the general population. Given the growing older population, the need for evidence-based guidance is essential. Regarding benefit derived from decompression alone versus decompression plus fusion for degenerative spondylolisthesis, the consensus is that all patients do not require a fusion; however, clarity around clearly identifying this cohort is lacking. Nevertheless, instrumented fusion is an effective strategy in the elderly. Numerous options exist, and individual patient characteristics as well as surgeon experience should be evaluated when planning surgery.