title: Paresis of the L5 nerve root after reduction of low-grade lumbosacral dysplastic spondylolisthesis: a case report.
abstract: We present a unique case of a 16-year-old patient who underwent lumbar decompression surgery (L4-S1), low-grade spondylolisthesis reduction surgery at L5-S1, and posterior instrumented fusion from L4 to the pelvis. Neurologic monitoring did not show any sustained changes throughout the operation. The patient was awoken from endotracheal anesthesia with grade 0 muscle function of the left extensor hallucis longus and tibialis anterior muscles resulting in left-sided foot drop. At the last follow-up 12 months after surgery, the patient had partial recovery, with grade 4 muscle function of the left extensor hallucis longus and tibialis anterior muscles. We suggest that early identification with direct nerve root stimulation and wake-up test immediately after reduction of spondylolisthesis will allow prompt release of the reduction and further foramen exploration, and increase the possibility of good postoperative nerve root recovery.
authors.affiliation: Departments of aOrthopedic Surgery, Spine and Scoliosis Service bOrthopedic Surgery, Pediatric Orthopedics Service, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York, USA.
authors.forename: Marios G
authors.initials: MG
authors.lastname: Lykissas
authors.forename: Alexander
authors.initials: A
authors.lastname: Aichmair
authors.forename: Roger
authors.initials: R
authors.lastname: Widmann
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Sama
mesh_terms: D000293:Adolescent; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D064795:Intraoperative Neurophysiological Monitoring; D008159:Lumbar Vertebrae / Q000601:surgery*; D019637:Orthopedic Procedures / Q000009:adverse effects*; D010291:Paresis / Q000209:etiology*; D013126:Spinal Nerve Roots / Q000293:injuries*; D013168:Spondylolisthesis / Q000601:surgery*