title: The management of high-grade spondylolisthesis and co-existent late-onset idiopathic scoliosis.
abstract: It is relatively common for a scoliosis deformity to be associated with a lumbar spondylolisthesis in adolescents (up to 48 % of spondylolistheses). In the literature two types of curve have been described: 'sciatic' or 'olisthetic'. However, there is no consensus in the literature on how best to treat these deformities. Some authors advocate a single surgical intervention, where both deformities are corrected; whereas, others advocate treating them as separate entities. In this situation, it has been shown that the scoliosis will correct with treatment of the spondylolisthesis.
  
  
  
  We present a 12-year-old girl who had a concomitant high-grade spondylolisthesis and scoliosis. Her main complaints were those of low back pain and an L5 radiculopathy. We took the decision to treat the spondylolisthesis surgically, but observe the scoliosis, rather than correcting them both surgically at the same sitting.
  
  
  
  Although the immediately post-operative radiographs showed persistence of the scoliosis, 1-year follow-up demonstrated full resolution of the deformity. This young lady also had relief of her low back pain and leg pain following the surgery.
  
  
  
  There are no standard guidelines and therefore, we discuss the management of this difficult problem, exemplifying a case of a young girl who had high-grade spondylolisthesis along with a clinically non-flexible scoliosis treated at our institution. We demonstrate that it is safe to observe the scoliosis, even in high-grade spondylolistheses.
authors.affiliation: Centre for Spinal Studies and Surgery, Queen's Medical Centre, Nottingham, NG7 2UH, UK. abhishek1212@gmail.com.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Srivastava
authors.affiliation: Centre for Spinal Studies and Surgery, Queen's Medical Centre, Nottingham, NG7 2UH, UK.
authors.forename: Edward
authors.initials: E
authors.lastname: Bayley
authors.affiliation: Centre for Spinal Studies and Surgery, Queen's Medical Centre, Nottingham, NG7 2UH, UK.
authors.forename: Bronek M
authors.initials: BM
authors.lastname: Boszczyk
mesh_terms: D002648:Child; D019299:Decompression, Surgical; D017586:Diskectomy; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000209:etiology / Q000628:therapy; D010027:Osteotomy; D011843:Radiculopathy / Q000209:etiology / Q000628:therapy; D012600:Scoliosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy*; D012720:Severity of Illness Index; D013123:Spinal Fusion; D013168:Spondylolisthesis / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Adolescent idiopathic scoliosis; Co-existent; High-grade spondylolisthesis