What is the recommended surgical treatment for a patient with degenerative spondylolisthesis resulting in stenosis?

• A. Decompression surgery alone
• B. Decompression and fusion surgery
• C. Spinal stabilization surgery
• D. Elective lumbar surgery

Answer: (A)

In cases of degenerative spondylolisthesis accompanied by stenosis, the most effective surgical intervention typically involves a combination of decompression and fusion surgery. This approach addresses both the narrowing of the spinal canal and the instability caused by the slippage of the vertebra.

Decompression surgery alone focuses on alleviating pressure from neural structures, which can provide symptomatic relief. However, without addressing the underlying instability, there is a significant risk of recurrence of symptoms or worsening of the condition. Fusion stabilizes the affected segments to prevent further displacement and can lead to more satisfactory long-term outcomes.

Other options might not comprehensively manage the complexities of degenerative spondylolisthesis with stenosis. For instance, spinal stabilization surgery is generally encompassed within the context of fusion. Elective lumbar surgery is too broad and not specific enough to highlight the necessary interventions for the condition. Hence, the combined treatment of decompression and fusion is regarded as the gold standard for addressing both the symptoms and the mechanical instability present in these patients.