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Patients with low-back pain, neurogenic claudication, or weakness with referable radiographic spinal stenosis and who have failed 3 to 6 months of conservative management.
Motor deficits or symptoms of cauda equina syndrome are indications for a more expeditious decompression.
Patients with extended stenosis or spondylosis causing compression but who have contraindications or comorbidities preventing an anterior or extended posterior fusion.
MRI findings of herniated disk fragments may prompt consideration of additional diskectomy and foraminotomy to further decompress the affected nerve roots.
Relatively contraindicated in patients with congenital or acquired pars defects—fusion is required to prevent dynamic instability and spondylolisthesis.
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