Traumatic lumbar Spondylolisthesis: Case Report

Abstract

Only few cases of traumatic spondylolisthesis (from the cranial to lumbosacral joint) have been reported to date. Recovery of neurological function is dependent on the time of decompression and stabilization. We highlight the paramount importance that the time past between injury and surgical decompression have on neurological recovery and implant durability. Authors present the case of a 26 years old patient who suffered a motor crash 10 days ago before admission in our institution for cauda equina syndrome (L5 level). He also presented abdominal trauma with left kidney contusion, spleen contusion, thoracic contusion and left fibular fracture. X-ray and MRI examinations of the lumbosacral spine revealed grade 3 of spondylolistesis (60% anterior dislocation L5 - S1, intervertebral disc and posterior ligaments laceration, severe compression of the dural sac and dural laceration with CSF leakage through the posterior muscular mass). Surgery performed 14 days after the injury consisted in a posterior approach with L5 laminectomy, dural decompression and duroplasty with fascia lata, segmental reduction and stabilization with transpedicular screws, L5-S1 discectomy and anterior intervertebral grafting with two tricortical iliac crest grafts. Posterior lumbar interbody fusion was carried out using titanium screws (Solas system). Decompression, reduction with L5, S1 pedicular screw fixation, L5 – S1 disc excision and anterior intervertebral grafting with two tricortical iliac crest grafts is an appropriate surgical technique wich offer a good stabilization and fine functional recovering.