Multilevel Thoracolumbar Spondylolysis with Spondylolisthesis at L4 on L5.
A 24-year-old male patient was initially evaluated for persistent back pain. The visual analogue scale (VAS) score was 7 points. Physical examination revealed a decreased range of lumbar spinal motion, which caused pain. Simple X-ray revealed Meyerding grade 1 spondylolisthesis at L4 on L5, with mild dome-shaped superior endplate and consecutive multilevel spondylolysis at T12-L5. Standing anteroposterior and lateral views of the entire spine revealed normal balance of sagittal and coronal alignment. A computed tomography scan revealed bilateral spondylolysis at T12-L4, left unilateral spondylolysis at L5, and spina bifida at L5 to sacral region. Magnetic resonance imaging revealed mild dural ectasia at the lumbar region. Due to the absence of any neurological symptoms, the patient was managed conservatively. He was rested a few weeks with corset brace and physiotherapy. After treatment, his back pain improved, VAS score changed from 7 to 2, and he was able to return to normal activity.
Department of Orthopedic Surgery, Eulji University School of Medicine, Daejeon, Korea.
Whoan Jeang
WJ
Kim
Department of Orthopaedic Surgery, National Medical Center, Seoul, Korea.
Young Dong
YD
Song
Department of Orthopedic Surgery, Eulji University School of Medicine, Daejeon, Korea.
Won Sik
WS
Choy
D000328:Adult; D001416:Back Pain / Q000209:etiology; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D011859:Radiography; D016135:Spinal Dysraphism; D013168:Spondylolisthesis / Q000000981:diagnostic imaging / Q000473:pathology; D013169:Spondylolysis / Q000000981:diagnostic imaging / Q000473:pathology; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D055815:Young Adult
Dura pathology; Spina bifida; Spondylolysis