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Case Review #B: Spondylolisthesis Surgery

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16 Year Old Female, with Spondylolisthesis symptomatic after a motor vehicle accident.

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Case Review #B: Spondylolisthesis Surgery

  1. 1. Case Review: 16 year old female, with Spondylolisthesis symptomatic after a motor vehicle accident.Robert S Pashman, MDScoliosis and Spinal Deformity Surgerywww.eSpine.com
  2. 2. Patient History• 16- year-old female• 3-year history of back pain and lower extremity pain primarily on the left.• Previous motor vehicle accident and was found to have fractures of the pars interarticularis• She states that she participated in gymnastics around the age of 10.• Failed conservative treatment
  3. 3. Pre-op X-rays
  4. 4. Oblique X-rays Oblique X-rays are taken to look at the spine from a diagonal angle. In particular, the surgeon is looking at the pars interarticularis. He or she is looking for a gap in the joint called Spondylolisthesis.
  5. 5. Flexion and Extension X-rays Flexion and Extension X- rays are taken to look for abnormal movement in the spine.
  6. 6. Indications for Surgery1. L5 spondylolysis.2. Bilateral L5 radiculopathy.
  7. 7. Surgical Strategy• Microscopic bilateral L5 laminotomy and foraminotomy.• Repair of L5 pars interarticularis fractures with local bone graft and instrumentation.
  8. 8. Post-op Films The patient did well after surgery. Her symptoms were resolved, and she resumed her normal activities.

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