Five-year follow-up after minimally invasive transforaminal lumbar interbody fusion versus decompression alone for grade 1 spondylolisthesis: are there any differences in outcomes?

J Neurosurg Spine 43:547–556, 2025

This multicenter, prospective registry study compares 60-month outcomes after minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) versus minimally invasive tubular decompression for Meyerding grade 1 degenerative spondylolisthesis. Patient-reported outcomes (ODI, NRS for back/leg pain, EQ-5D, NASS satisfaction) improved significantly in both cohorts, with MIS TLIF showing greater back-pain reduction and higher satisfaction rates.

Durability differs: MIS TLIF had a markedly lower 5-year reoperation rate than MIS decompression (2.8% vs 15.5%), and multivariable analysis found fusion reduced reoperation odds despite similar long-term PROs. Authors conclude both MIS approaches benefit selected patients, but fusion offers superior reoperation durability.