title: Isolate metastasis of listhetic vertebra.
abstract: METHODS
  Case report.
  
  
  OBJECTIVE
  To document the case of isolated metastasis in an isthmic spondylolisthesis in the adult.
  
  
  BACKGROUND
  The progression of isthmic spondylolisthesis occurs infrequently in the adult. Previous reports have pointed out the pathogenic responsibility of the progressive disc collapse.
  
  
  METHODS
  A 58-year-old woman was evaluated for severe back and bilateral leg pain. Standing radiographs of her lumbar spine showed L5-S1 spondylolisthesis. CT and MRI scans demonstrated a tumor infiltration of the L5 listhetic vertebra.
  
  
  RESULTS
  Bilateral interruption of the posterior arch was noted at surgery. A posterior decompression with an L3-S1 pedicle screw fixation was performed without complication. Leg pain and paraparesis promptly regressed. A solitary localization of an undifferentiated adenocarcinoma of unknown origin was diagnosed. The patient refused further surgery and died three years after the operation.
  
  
  CONCLUSIONS
  The progression of isthmic spondylolisthesis occurs infrequently in the adult. This case shows that tumor infiltration is a potential cause for the onset/progression of spondylolisthesis in the adult. An MRI or CT scan of the spine is recommended in skeletally mature patients with isthmic spondylolisthesis who sustain severe and acute exacerbation of their back pain.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, University Magna Græcia, Catanzaro, Italy. golimpiogo@hotmail.com
authors.forename: Olimpio
authors.initials: O
authors.lastname: Galasso
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gasparini
authors.forename: Massimo
authors.initials: M
authors.lastname: Mariconda
authors.forename: Francesco
authors.initials: F
authors.lastname: Signorelli
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000556:secondary*; D001416:Back Pain / Q000209:etiology; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology*; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis*; D020335:Paraparesis / Q000209:etiology; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000556:secondary*; D013168:Spondylolisthesis / Q000209:etiology*