title: Transsacral transdiscal L5-S1 screws for the management of high-grade spondylolisthesis in an adolescent.
abstract: The surgical management of high-grade spondylolisthesis in adolescents remains a controversial issue. Because the basic procedure, posterolateral fusion, is associated with a significant rate of pseudarthrosis and listhesis progression, there is a pressing need for alternative surgical techniques. In the present report, the authors describe the case of an adolescent patient with significant low-back pain who was found to have Grade IV spondylolisthesis at L5-S1 that was treated with transsacral transdiscal screw fixation. Bilateral pedicle screws were placed starting from the top of the S-1 pedicle, across the L5-S1 intervertebral disc space, and into the L-5 body. At 14 months after surgery, the patient had considerable improvement in his pain and radiographic fusion across L5-S1. The authors conclude that transsacral transdiscal pedicle screws may serve as an efficacious and safe option for the correction of high-grade spondylolisthesis in adolescent patients.
authors.affiliation: Division of Pediatric Neurosurgery, Texas Children's Hospital; and.|Department of Neurosurgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Ali
authors.initials: A
authors.lastname: Palejwala
authors.affiliation: Division of Pediatric Neurosurgery, Texas Children's Hospital; and.|Department of Neurosurgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Jared
authors.initials: J
authors.lastname: Fridley
authors.affiliation: Division of Pediatric Neurosurgery, Texas Children's Hospital; and.|Department of Neurosurgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Andrew
authors.initials: A
authors.lastname: Jea
mesh_terms: D001863:Bone Screws; D002648:Child; D019468:Disease Management; D006801:Humans; D008297:Male; D012447:Sacrum / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013168:Spondylolisthesis / Q000601:surgery*; D016896:Treatment Outcome
keywords: BMP = bone morphogenetic protein; MCID = minimal clinically important difference; ODI = Oswestry Disability Index; SRS-22 = Scoliosis Research Society-22; adolescent spine; spondylolisthesis; transsacral screw