A 36-year-old man with spondylolisthesis diagnosed at age 9 presented as an outpatient complaining of episodic low back pain. There were no neurologic signs or symptoms. Plain radiographs demonstrated L5 spondyloptosis, with a large fragment of the body of L5 apparently fused to the anterosuperior aspect of the sacrum (Fig. 1, arrows). This was confirmed on computed tomography (Fig. 2, arrows). Magnetic resonance imaging revealed spinal stenosis (Fig. 3). Physical therapy was prescribed, and the patient has kept up his active lifestyle that includes working as a plumber and participating in motocross. The treatment of highgrade spondylolisthesis is controversial, as opinion is divided between in situ fusion techniques and reduction with stabilization and L5 vertebral body resection [1–5]. Although in situ fusion does not correct the deformity, it has a lower risk of neurologic injury [4,5]. This unique case of a spontaneously fused L5 vertebra supports the use of in situ arthrodesis for the treatment of nontraumatic spondyloptosis
Spontaneous fusion of L5 spondyloptosis: Should we learn from nature?
Di Martino, Alberto;
2012
Abstract
A 36-year-old man with spondylolisthesis diagnosed at age 9 presented as an outpatient complaining of episodic low back pain. There were no neurologic signs or symptoms. Plain radiographs demonstrated L5 spondyloptosis, with a large fragment of the body of L5 apparently fused to the anterosuperior aspect of the sacrum (Fig. 1, arrows). This was confirmed on computed tomography (Fig. 2, arrows). Magnetic resonance imaging revealed spinal stenosis (Fig. 3). Physical therapy was prescribed, and the patient has kept up his active lifestyle that includes working as a plumber and participating in motocross. The treatment of highgrade spondylolisthesis is controversial, as opinion is divided between in situ fusion techniques and reduction with stabilization and L5 vertebral body resection [1–5]. Although in situ fusion does not correct the deformity, it has a lower risk of neurologic injury [4,5]. This unique case of a spontaneously fused L5 vertebra supports the use of in situ arthrodesis for the treatment of nontraumatic spondyloptosisI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
