Guidelines
One RCT evaluated the rate of fusion with and without Knodt rods in patients with a diagnosis of multiple level foraminal stenosis. The rates of fusion, patient-reported functional status and lengths of postoperative hospital stays were not significantly different between the two groups.
A controlled trial compared laminectomy with and without fusion in patients with chronic symptoms The fusion group reported significantly greater pain relief in the back and legs than the non-fusion group. At mean follow-up of 3.0 years, excellent or good outcome rates were significantly greater for the fusion group.
An attempted meta-analysis on this topic found only four non-randomized studies comparing surgery with and without fusion for herniated disc. Three reported no significant difference between the two groups.
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