title: Minimally invasive lumbopelvic instrumentation for traumatic sacrolisthesis in an elderly patient.
abstract: OBJECTIVE
  We present a novel minimally invasive technique for lumbopelvic instrumentation in selected elderly patients suffering from traumatic sacrolisthesis. An 82-year-old female suffered from sacrolisthesis after a fall. She developed significant low back pain and bilateral lower extremity radiculopathy. Preoperative radiographs and magnetic resonance imaging sequences demonstrated the fracture dislocation between S1 and S2 with compromise of the spinal canal. Lumbopelvic instrumentation was sought to offer fixation and allow mobilization; however, open lumbopelvic instrumentation techniques have significant morbidity, especially in this patient population of elderly patients with medical comorbidities.
  
  
  METHODS
  A minimally invasive technique employing percutaneous pedicle screws at L5 and S1 coupled with percutaneous S2 iliac screws was employed.
  
  
  CONCLUSIONS
  The patient tolerated the procedure well without any complications or morbidity. At the last follow-up of 14 months, she was ambulating without assistance with near total resolution of back pain and radicular pain. Radiographs obtained at 8 months' follow-up demonstrated fusion across the fracture line. Although further follow-up data is still needed to establish the durability of this technique in the long-term, this minimally invasive technique for lumbopelvic instrumentation can be considered as an option in elderly patients with traumatic sacrolisthesis, whose need for early mobilization and medical comorbidities preclude the use of an open lumbopelvic fixation procedure.
authors.affiliation: Department of Neurologic Surgery, The George Washington University Medical Center, The George Washington University School of Medicine, 2150 Pennsylvania Avenue, NW, Suite 7420, Washington, DC 20037, USA. jwind@gwu.edu
authors.forename: Joshua J
authors.initials: JJ
authors.lastname: Wind
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Burke
authors.forename: Khalid H
authors.initials: KH
authors.lastname: Kurtom
authors.forename: Fabio
authors.initials: F
authors.lastname: Roberti
authors.forename: Joseph R
authors.initials: JR
authors.lastname: O'Brien
mesh_terms: D000058:Accidental Falls; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000209:etiology / Q000601:surgery*; D012447:Sacrum / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation; D013168:Spondylolisthesis / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome