Spinal Arthrodesis with Acute Reduction in a High-Grade Isthmic Type IIC Spondylolisthesis

Abstract

The objective of this study was to present a case of Spondylolisthesis of the Isthmic Type (IIC), with Meyerding Grade III, high-grade dysplastic morphology, presenting with no neurologic deficits, which underwent spinal arthrodesis with acute reduction of L5-S1 segment. Spondylolisthesis itself is rare, presenting in 6% of the adult population with low back pain. Among these cases, 11.3% are characterized by high-grade spondylolisthesis, often accompanied by neurological deficits. This study presents the case of a young adult woman (32 years old) with spondylolisthesis of the Isthmic Type (IIC – Acute Pars Fracture), Meyerding Grade III (slippage of >50%), presenting with no neurologic deficits. We present her outcomes after undergoing instrumented spinal arthrodesis with a reduction in terms of radiographic measurements, pain, presence of post-operative neurologic deficits, and return to work. Post-operatively, the lumbar lordosis angle improved from 84 degrees to 48 degrees. There was less pain, greater functional independence in terms of activities of daily living, and eventual return to work. Even for high-grade spondylolisthesis, reduction of the affected level with instrumented fusion may provide excellent outcomes in terms of spinal alignment, pain, and return to work.

Keywords

• pars fracture
• high-grade
• acute reduction
• lumbar lordosis
• spinal arthrodesis