Case Review #2: Isthmic Spondylolisthesis Grade IV

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Case review: A 58 year old female with Isthmic Spondylolisthesis status post surgery. She continued to experience back pain and leg pain, and was treated with spinal surgery.

Health & Medicine

Isthmic Spondylolisthesis
Grade IV:

Treated with Anterior and Posterior
Spinal Fusion

Robert S. Pashman, MD

Scoliosis and Spinal Deformity Surgery
www.eSpine.com

Isthmic Spondylolisthesis
• 58 year old female
• Diagnosis: Grade IV Isthmic Spondylolisthesis
• Posterior spinal fusion in 1999, continuous pain.
• Patient referred to Cedars Sinai in 2002.
• Failed fusion at L5/S1, progressive
spondylolisthesis at L5/S1, and L4/L5
• Low back pain, leg pain
• Failed to respond to conservative therapy

Surgical Strategy
• Three stage operation
• Decompression L4-S1
• Anterior interbody fusion
L4-S1, using autogenous
hip bone graft
• Placement of sacral ileal
L4 fixation L4-pelvis
• Anterior spondylolisthesis
S1 reduction
• Posterior Spinal Fusion L4
Pelvis to Sacral Pelvis

Results

Patient’s symptom’s were resolved post-operatively

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