title: Grade 4 spondylolisthesis of the L5 vertebra associated with dural ectasia in neurofibromatosis.
abstract: Spondylolisthesis associated with neurofibromatosis is rare, and only 12 cases have been reported so far. However, only one report of grade 4 spondylolisthesis with neurofibromatosis has been reported in the literature. A 15-year-old boy with neurofibromatosis was admitted for back pain and neurological claudication. Radiograph showed grade 4 spondylolisthesis of the L5 vertebra with scalloping of the L4-L5 vertebrae. L4-L5 laminectomy, reduction, L3-S1 posterior instrumentation and fusion were performed. The reduction of the spondylisthesis was done entirely from the posterior approach using pedicle screws. Radiography at four months showed a broken S1 screw with a loss of reduction. The patient was re-operated on, to provide additional stability with pelvic fixation. He was pain-free with a good fusion at the two-year follow-up. Adequate posterior stabilisation with fusion gives good results in grade 4 spondylolisthesis associated with neurofibromatosis and dural ectasia.
authors.affiliation: Scoliosis Research Institute, Department of Orthopedics, Korea University Guro Hospital, 80 Guro-Dong, Guro-Gu, Seoul 152-703, Korea.
authors.forename: H N
authors.initials: HN
authors.lastname: Modi
authors.forename: S
authors.initials: S
authors.lastname: Srinivasalu
authors.forename: S W
authors.initials: SW
authors.lastname: Suh
authors.forename: J H
authors.initials: JH
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D001416:Back Pain; D001863:Bone Screws; D004108:Dilatation, Pathologic / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D016268:Internal Fixators; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D017253:Neurofibromatoses / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D012600:Scoliosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D013168:Spondylolisthesis / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery