Spondylolisthesis Case 2

Case Review #2: Isthmic Spondylolisthesis Grade IV from Robert Pashman

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.

Case Review:

Isthmic Spondylolisthesis Grade IV:Treated with Anterior and Posterior Spinal Fusion

Patient History:

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 fixation L4-pelvis Anterior spondylolisthesis reduction Posterior Spinal Fusion L4 to Sacral Pelvis


Patient’s symptom’s were resolved post-operatively