Lumbar Interbody Fusion: Is it Necessary?

Lumbar interbody fusion techniques are growing in popularity and they encompass transforaminal, direct lateral, and anterior approaches. Although there is some evidence of superiority of interbody fusions in reducing pseudarthrosis and improving overall surgical outcomes, high-quality data remains lacking. Furthermore, and irrespective of the given approach, interbody surgeries can pose harm and predispose to certain complications. Careful patient selection is therefore crucial. This manuscript will review the proper indications of interbody fusion in patients with degenerative spondylolisthesis, degenerative scoliosis, isthmic spondylolisthesis, and the role of interbody techniques in achieving successful arthrodesis and deformity correction.