Austevoll IM, Hermansen E, Fagerland MW, et al. - Findings from this open-label, multicenter, noninferiority trial suggest the noninferiority of decompression alone to decompression with instrumented fusion in patients who underwent surgery for degenerative lumbar spondylolisthesis, over a period of 2 years.

• Most of the patients had symptoms (leg pain and back pain) for more than a year.

• The mean change from baseline to 2 years in the Oswestry Disability Index (ODI) score was −20.6 vs −21.3 in the decompression-alone group and fusion group, respectively.

• In the modified intention-to-treat analysis, a reduction of at least 30% in the ODI score was recorded in 71.4% patients in the decompression-alone group and 72.9% patients in the fusion group; this suggests the noninferiority of decompression alone.

• Reoperation was performed in 12.5% patients in the decompression-alone group vs 9.1% patients in the fusion group.