Association of Postoperative Slip Reduction With Patient-Reported Outcomes at Two Years After Fusion Surgery for Low-Grade Degenerative Spondylolisthesis: A Single-Centre Study
Global Spine Journal · 28 Aug 2026
† Impact is the editorial-priority score. All scores are out of 100. Clinical is a stored clinical-importance score from the earlier method; it has not been recalculated.
Why it matters
This addresses an unresolved question in spine surgery, namely whether the degree of slip correction achieved during fusion for low-grade spondylolisthesis matters clinically, which could inform intraoperative reduction targets.
The evidence
This single-centre retrospective study followed 160 patients who underwent lumbar fusion with an attempted intraoperative reduction for low-grade degenerative spondylolisthesis, and asked whether the amount of slip correction achieved (not just whether reduction was attempted) predicted patient-reported outcomes at 2 years. Each additional percentage-point of postoperative slip reduction was associated with a 4.51-point greater relative improvement in ODI and a 3.76-point greater relative improvement in low back pain (both p<0.001), while changes in lumbar lordosis, PI-LL, and other spinopelvic parameters correlated with slip reduction but were not independently linked to clinical outcomes.
Relative postoperative improvement in ODI (ΔODI_rel): Mean difference 4.51 (95% CI 3.34 to 5.67; ODI). The interval favours the first group; the size of the benefit needs clinical interpretation.
Why this rigour score?
Prospective cohortDesign starting point: 40
Raised the score
- 24-month follow-up+3.4
- Consecutive enrolment+2.5
Lowered the score
- No correction for multiple comparisons−3.4
- A single centre's own patients−3.4
Methods at a glance
Recorded assessment- Confounding adjustmentMultivariable regression
- Covariate balance confirmedNot applicable
- Outcome assessors blindedNot reported
- Comparable start of follow-upNot applicable
- Adequate statistical powerCalculation absent
- Prospective registrationNot reported
Not reported does not mean not done. Checks have different weights; this is not a count of boxes ticked.
See the full score breakdown
- Study design starting point
- 40
- 24-month follow-up
- +3.4
- No correction for multiple comparisons
- −3.4
- A single centre's own patients
- −3.4
- Consecutive enrolment
- +2.5
- Journal prior (not an observed method)
- +1.5
- Final rigour score rounded
- 41 / 100
Study design sets the starting point and a ceiling of 82. Recorded methods then adjust the score. Points are shown to one decimal place; the final score uses unrounded values.
Checklist from the stored appraisal. “Not met” describes the recorded criterion; it does not always produce a deduction. This overview supports reading the full study.
For journal club
1.If greater slip reduction is associated with better patient-reported outcomes, should surgeons more aggressively pursue reduction intraoperatively even at the cost of longer operative time or added risk?
2.Given that sagittal alignment changes did not independently predict outcomes, should surgical planning for low-grade DLS fusion prioritise slip correction over alignment restoration?
Original publication title
Association of Postoperative Slip Reduction With Patient-Reported Outcomes at Two Years After Fusion Surgery for Low-Grade Degenerative Spondylolisthesis: A Single-Center Study