Does it make sense to you that a 80-year-old grandmother would need surgery to fuse her spine? She’s so stiff, I doubt her spine even moves. But the surgeon is recommending a spinal fusion for a condition they call degenerative spondylolisthesis. What can you tell me about this?

Spondylolisthesis is a condition in which one of the vertebral bones slips forward over the one below it. Spondylolisthesis alters the alignment of the spine. As the bone slips forward, the nearby tissues and nerves may become irritated and painful. In older adults, degeneration of the disc and facet (spinal) joints can lead to spondylolisthesis. Spondylolisthesis from degeneration usually affects people over 50 years old. This condition occurs in African Americans more often than in whites. Women are affected more often than men.

Spinal fusion has become a very popular way to treat age-related degenerative spinal conditions like spondylolisthesis. In fact, Medicare spending for spinal fusions has gone up 100 per cent in the last 10 years. Patients get pain relief, which means they feel better and engage in more of their everyday activities. For older adults, that’s an important factor in remaining independent.

There have been some doubts raised that back surgery really changes things or does more than line the pockets of health care professionals. Experts are taking a closer look at these kinds of issues. Patients are being followed for more than a few months after surgery (some studies are tracking patients for years) to see if the final results are worth the money spent.

Surgeons are also investigating which procedure used works the best and has the fewest complications. In a recent study from Dartmouth Medical School, the results of three different methods of spinal fusion were compared. They found that patients were better off than before surgery but the final results (measured in terms of pain and physical function) were the same no matter what type of surgery was done. Fusion rates were better when metal plates and/or screws were used. But clinical function wasn’t necessarily greater or different based on fusion rates.

We can’t say whether or not the grandmother you mentioned needs a spinal fusion or will benefit from this procedure. But your concerns are important. You may want to go with her to an appointment with the surgeon and get the facts for yourself. Understanding the condition and the proposed treatment (as well as asking about alternative treatments) may help you in this matter.