Yes or No? Spinal Fusion for Spondylolisthesis

A lumbar spinal fusion is one of the biggest decisions in spine care—and many patients with spondylolisthesis are advised to have a fusion when it may not actually be necessary. In this video, I walk you through the five key factors I use as a (non-surgeon) spine doctor to decide when spinal fusion is appropriate, when it can be avoided, and when it should not be delayed. These are the same principles I use when patients come to me with conflicting surgical opinions. You’ll learn: How spondylolisthesis grade affects the need for fusion Why instability on flexion–extension X-rays matters (and when it doesn’t) The critical difference between degenerative vs. isthmic spondylolisthesis How bone health, hormones, and metabolism influence fusion success Why symptoms—not imaging alone—ultimately drive the decision At the end of the video, I apply this framework to three real clinical cases, including: Severe spinal stenosis with low-grade spondylolisthesis Isthmic spondylolisthesis with instability but modifiable symptoms Progressive neurological decline where fusion was indicated—but outcomes were still complex Watch this video if you or someone you know is: *Deciding on a spinal fusion *Getting conflicting surgical recommendations *Wanting a practical decision framework from a medical doctor #SpinalFusion #Spondylolisthesis #BackSurgery #SpineHealth #PatientEducation