spondylolisthesis: when one vertebra slips forward on another.
Traumatic lumbar spondylolisthesis is an uncommon injury and its mechanism and treatment remain controversial. A combination of multiple forces may be responsible for the occurrence of the trauma and in English literatures, the injury was reported to be treated using different surgical approaches. We describe a patient with a traumatic spondylolisthesis of L5. Reduction, decompression and fixation were performed using posterior approach and at the last follow-up the case got a satisfactory result.
We treat more than 600 patients with spondylolisthesis each year.
The patient was admitted into trauma department of our hospital and X-ray examination () revealed traumatic lumbar spondylolisthesis of L5 on S1, fracture of left L1-3 transverse processes, bilateral fracture of transverse process and spinous process of L4, and fracture of spinous process of L5. MRI revealed L5 spondylolisthesis and disruption of L5 intervertebral disc ().
Spondylolisthesis | Symptoms, causes & treatment …
(9a) T1- and (9b) T2-weighted sagittal images in a patient with spondylolisthesis reveal clear pars defects (arrows). A horizontal configuration of the L5 neural foramina is readily apparent (red outline), with resultant foraminal stenosis. Compare this configuration with the normal keyhole appearance of the L4-5 foramina (blue outline). This horizontal configuration is typical in patients with spondylolisthesis due to spondylolysis.
Traumatic Spondylolisthesis of Axis (Hangman's …
At times, direct visualization of a pars defect is difficult on sagittal MR images, and thus it may be difficult to determine whether a patient with spondylolisthesis has a degenerative origin or if the malalignment is due to spondylolysis. In such cases, characteristic ancillary findings can be utilized to differentiate degenerative spondylolisthesis from isthmic spondylolisthesis. An appearance that we have found to be highly characteristic of isthmic spondylolisthesis is the horizontal neural foramina sign. In patients with spondylolysis, the neural foramina often assume a horizontal configuration on far lateral sagittal images (9a,9b). This feature is not present in degenerative spondylolisthesis, and the configuration also accounts for radiculopathy due to foraminal stenosis in patients with more severe isthmic spondylolisthesis.