Degenerative Grade 3 Spondylolisthesis Management: A Case Report and Literature Review

Abstract

Degenerative spine disorders are very common in the aging population. Degenerative spondylolisthesis is a relatively uncommon cause of chronic back pain in these patients. We present a case of high-grade spondylolisthesis managed with posterior lumbar interbody fusion (PLIF) and reduction of the listhesis with excellent results. A 56-year-old woman presented with chronic lower back pain managed as an outpatient for over 5 months with no relief. She had no history of trauma or risk factors for malignancy. Lumbosacral CT showed Meyerding grade 3 anterolisthesis of the fifth lumbar vertebra with complete L5-S1 disc collapse and bilateral spondylolysis. An MRI confirmed the findings. There was no spinal canal stenosis. The patient was managed with L4-L5-S1 transpedicular fixation and L5-S1 interbody cage with reduction of the listhesis. The patient had an incidental intraoperative dural tear which was repaired primarily and a wound drain was kept for 5 days without complications. The patient was ambulating by day 5 and was discharged without complications on day 10. Degenerative spondylolisthesis can cause chronic back pain with or without a history of trauma. Although no specific clinical features exist for this condition, it should be suspected in elderly patients even in the absence of a history of trauma. Surgical management in high-grade spondylolisthesis is indicated with interbody fixation and reduction.

Comparative Analysis of Open Transforaminal Lumbar Interbody Fusion and Wiltse Transforaminal Lumbar Interbody Fusion Approaches for Treating Single-Level Lumbar Spondylolisthesis: A Single-Center Retrospective Study

“…At its core, it signifies a holistic approach that aims for optimal therapeutic outcomes while minimizing collateral damage to the patient's body. Shorter incisions are, of course, a characteristic feature, but the true essence lies in the preservation of soft tissue integrity and reducing the overall traumatic impact of the procedure on the body [16][17][18][19][20]. The Wiltse approach shows this philosophy, offering a method that markedly diminishes muscle trauma.…”

“…In addition to the physiological benefits, MIS TLIF has been shown to result in less intraoperative blood loss, lower postoperative pain, and faster recovery times compared with open TLIF [12,13]. The advent of advanced visualization tools, such as the microscope and exoscope, has been revolutionary in the field of spinal surgery, especially for procedures like TLIF [14][15][16]. Beyond visualization, its ergonomic design, which allows surgeons to view a screen rather than peer through eyepieces, mitigates physical strain, enabling longer periods of focused surgery.…”

Quantifying Lumbar Foraminal Volumetric Dimensions: Normative Data and Implications for Stenosis—Part 2 of a Comprehensive Series

“…Spondylolisthesis, characterized by vertebral displacement, contributes to spinal instability and potential nerve compression [ 26 ]. This condition manifests in various forms, including dysplastic, isthmic, degenerative, traumatic, and pathologic spondylolisthesis, each with distinct causes ranging from congenital abnormalities and repetitive trauma to degenerative changes and bone diseases [ 27 , 28 , 29 , 30 , 31 ].…”