RCT Cohort •

Study design: Retrospective cohort study. Clinical question or objective: Is there a benefi t to additional transforaminal lumbar interbody fusion (TLIF) if a solid posterolateral (PL) fusion can be achieved with routine bone morphogenetic protein (BMP) use in low-grade spondylolisthesis? Methods: We performed a retrospective review of patients who had undergone surgery for grade I or II lumbar spondylolisthesis stratifi ed into two groups. Group 1 had 46 patients who underwent TLIF along with PL instrumented fusion. Group 2 had 40 patients who underwent PL instrumented fusion alone. In both groups, adequate posterior decompression with pedicle screw instrumentation was performed and rhBMP-7 was used. All patients were evaluated clinically using the Oswestry Disability Index (ODI) and by independent radiological examination at 3 and 12 months. Results: At a minimum follow-up of 12 months, there was no statistically signifi cant difference in the rate of fusion. In addition, there were no differences in the proportion of patients who had a minimal clinically signifi cant difference in their ODI. There was a similar rate of complications between each cohort. Conclusions: The use of BMP was associated with a high rate of PL lumbar fusion. In the presence of a PL fusion, there appears to be little clinical benefi t to additional anterior TLIF in degenerative spondylolisthesis. Original research—In the era of recombinant BMP, does additional anterior stabilization add value (…) 21—25 In the era of recombinant BMP, does additional anterior stabilization add value to a posterolateral fusion