Urakawa H, Jones T, Samuel A, et al. - Researchers investigated the rate, timing, and risk factors of subsequent fusion for patients after decompression alone for lumbar spinal stenosis (LSS) with spondylolisthesis via performing a retrospective cohort study of 5,875 patients in the public insurance population (PI population) and 1,456 patients in the private insurance population (PrI population). Subsequent fusion was performed in 1.9% at 1 year, 3.5% at 2 years, and 6.7% at 5 years in the PI population, whereas it was performed in 4.3% at 1 year, 8.9% at 2 years, 14.6% at 5 years in the PrI population. Per findings, good outcomes are achieved in some patients with LSS with spondylolisthesis by performing decompression surgery alone. However, surgeons should be aware of the significance of recognizing that patient age less than 70 years, symptomatic neurogenic claudication, and presence of RA and/or CVD are significant independent factors linked with greater likelihood of needing secondary fusion surgery.