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Abstract Spondylolisthesis is a common spine disease. Clear guidelines for treatment of spondylolisthesis are present, however when is accompanied with adjacent segment degeneration, the management of this adjacent degenerated level is not well established.This study included 20 patients devided into group A with fusion of the displaced level only and group B with inclusion of the adjacent degenerated level in fusion.Concluded that we can extend the fixation to include the adjacent degenerated levels, and the extent of the fusion aims to elimination of the adjacent degenerated disc that cause painful disc disease, and to achieve the best sagittal alignment with restoration of lumbar lordosis and global balance that seems to be vital to a successful surgical outcome |