Identifying preoperative radiographic metrics to guide surgical selection in lumbar spondylolisthesis and stenosis

A broader definition of spinal instability may be needed when deciding whether to include fusion in treating lumbar stenosis with spondylolisthesis. Preoperative vertical instability and dynamic slip may be important in addition to translational instability. Larger prospective studies are warranted, but these metrics could help guide the decision on whether fusion is necessary and likely to improve outcomes for a common spinal disorder.