Upright MRI Follow-Up for Decompression and Interlaminar Stabilization in Low-Grade L4/L5 Spondylolisthesis…

Cohort studyInternational journal of spine surgery· Jul 2026

Upright MRI Follow-Up for Decompression and Interlaminar Stabilization in Low-Grade L4/L5 Spondylolisthesis Suggests Reduced Reoperation Rates Compared With Fusion or Decompression Alone.

Julia E Reich, Andrei Slavici, Juan M Vinas-Rios … Vincent J Heck

SpineCohort studyTreatmentQ1IF 1.9

Only 3% of patients needed reoperation after decompression with interlaminar stabilization at L4/L5

Upright MRI Follow-Up for Decompression and Interlaminar Stabilization in Low-Grade L4/L5 Spondylolisthesis Suggests Reduced Reoperation Rates Compared With Fusion or Decompression Alone.

Julia E Reich … Vincent J Heck

International journal of spine surgery · Jul 2026 · Q1 in Surgery

Background

While spinal fusion is the standard treatment for symptomatic low-grade spondylolisthesis, evidence on motion-preserving alternatives such as decompression with interlaminar stabilization (D+ILS) remains limited.

Purpose

This study aims to descriptively evaluate clinical and radiological outcomes after D+ILS at L4/L5 under strict inclusion criteria, with a specific focus on dynamic spinal assessment using upright magnetic resonance imaging (magnetic resonance imaging).

Methods

This prospective observational study involved 30 patients with degenerative low-grade spondylolisthesis at L4/L5 treated with D+ILS using the Coflex interlaminar stabilization device.

n = 30 patients

3%

Results

3%

reoperation for adjacent-segment degeneration was rare after this motion-preserving approach

n = 30 patients

More results

Radiological progression of facet joint osteoarthritis and disc degeneration was mild.

Spinopelvic parameters and multifidus muscle morphology remained largely unchanged.

Clinically, there were significant improvements in pain, functional disability, and ambulation.

“

Conclusion · 1 of 3

This study is the first to assess D+ILS in a strictly selected cohort using upright magnetic resonance imaging to evaluate postoperative mechanics at mid-term follow-up under physiological load.

Conclusion · 2 of 3

Our findings suggest that D+ILS may be a feasible motion-preserving treatment concept in carefully selected patients with stable L4/L5 spondylolisthesis.

Conclusion · 3 of 3

However, given the exploratory design and small cohort, these observations should be interpreted as descriptive and hypothesis generating and warrant confirmation in controlled trials.

Upright MRI Follow-Up for Decompression and Interlaminar Stabilization in Low-Grade L4/L5 Spondylolisthesis Suggests Reduced Reoperation Rates Compared With Fusion or Decompression Alone.

Upright MRI Follow-Up for Decompression and Interlaminar Stabilization in Low-Grade L4/L5 Spondylolisthesis Suggests Reduced Reoperation Rates Compared With Fusion or Decompression Alone.

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