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Lumbosacral Traumatic Spondylolisthesis L5 to S1-Classification and Surgical Management of a Difficult Presentation – Lumbar Spinal Stenosis

This article discusses a rare condition called lumbosacral traumatic spondylolisthesis L5-S1, which occurs when the L5 vertebra is displaced due to trauma. The article emphasizes the difficulty in classifying and managing this condition, as well as the lack of consistent results in the literature. The case study presented in the article involves a 53-year-old patient who experienced cauda equina syndrome as a result of this condition and required immediate surgical intervention. The surgical management included a posterior approach for screw fixation, spinal decompression, and fusion. The patient experienced immediate improvement after the surgery and was discharged on the third postoperative day. The article concludes that further study is needed to better understand this condition, and surgical management is currently the preferred approach

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most experienced treatment clinic in London

Published article

CONCLUSION: Lumbosacral traumatic spondylolisthesis L5-S1 is an unusual pathology that requires further study as there is currently no standardized classification. Surgical management is the gold standard and includes open reduction with short transpedicular screw fixation in segment L5-S1 and other surgical interventions such as extension to the pelvis with iliac screws, screws to the L4 vertebral body, and use of lumbar interbody fusion cages.

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Int J Spine Surg. 2023 Oct 29:8553. doi: 10.14444/8553. Online ahead of print.ABSTRACTINTRODUCTION: Lumbosacral traumatic spondylolisthesis L5-S1 is a rare clinical entity that compromises the stability of the L5 vertebra by displacing it anteriorly, laterally, or posteriorly on the S1 vertebral body secondary to osteotendinous and/or articular compromise of this segment due to trauma. This,

Int J Spine Surg. 2023 Oct 29:8553. doi: 10.14444/8553. Online ahead of print.

ABSTRACT

INTRODUCTION: Lumbosacral traumatic spondylolisthesis L5-S1 is a rare clinical entity that compromises the stability of the L5 vertebra by displacing it anteriorly, laterally, or posteriorly on the S1 vertebral body secondary to osteotendinous and/or articular compromise of this segment due to trauma. This pathology is difficult to classify and manage; although surgical management remains the gold standard, short- and long-term results in the literature are scarce and highly variable.

PATIENT PRESENTATION: We present the case of a 53-year-old patient with lumbar trauma due to a free fall from a height of 6 meters. The fall resulted in cauda equina syndrome secondary to lumbosacral traumatic spondylolisthesis L5-S1, which required immediate surgical management.

INTERVENTION AND OUTCOME: For surgical management, we used a posterior approach for L5-S1 transpedicular screw fixation, spinal decompression, bilateral root foraminotomy of L5, and L5-S1 open transforaminal lumbar interbody fusion with open reduction. After the operation, the patient reported immediate improvement of postoperative lower extremities pain and was discharged on the third postoperative day after achieving clinical improvement with physical therapy and bladder rehabilitation exercises.

CONCLUSION: Lumbosacral traumatic spondylolisthesis L5-S1 is an unusual pathology that requires further study as there is currently no standardized classification. Surgical management is the gold standard and includes open reduction with short transpedicular screw fixation in segment L5-S1 and other surgical interventions such as extension to the pelvis with iliac screws, screws to the L4 vertebral body, and use of lumbar interbody fusion cages.

PMID:37903540 | DOI:10.14444/8553

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Lumbosacral Traumatic Spondylolisthesis L5 to S1-Classification and Surgical Management of a Difficult Presentation

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Int J Spine Surg. 2023 Oct 29:8553. doi: 10.14444/8553. Online ahead of print.ABSTRACTINTRODUCTION: Lumbosacral traumatic spondylolisthesis L5-S1 is a rare clinical entity that compromises the stability of the L5 vertebra by displacing it anteriorly, laterally, or posteriorly on the S1 vertebral body secondary to osteotendinous and/or articular compromise of this segment due to trauma. This

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