Progression of Diagnostic Imaging Findings of a Patient With Traumatic Spondylolisthesis Secondary to Unilateral Facet Fractures: A Case Report

Abstract

Objective: The purpose of this case study is to describe the diagnostic imaging studies of a patient who had a traumatic spondylolisthesis at L5-S1 secondary to unilateral facet fractures. Clinical Features: A 21-year-old man experienced a rollover motor vehicle crash that led to low back pain and progressive left-sided radiculopathy. Later, he sought treatment from a doctor of chiropractic because he continued to have low back pain with progressive pain down his left leg. A magnetic resonance imaging study demonstrated a left paracentral disc protrusion at L5-S1. Follow-up computed tomography demonstrated multiple transverse process fractures and left-sided L5-S1 facet fractures with spondylolisthesis that progressed over time. Intervention and Outcome: The patient was referred for a neurosurgical consultation 10 months after the injury. At 12 months after the injury, he underwent transforaminal lumbar interbody fusion with a posterior approach. The patient's pain and radicular symptoms resolved after the surgery. Conclusion: This patient exhibited posterior element fractures, had continued symptom progression, and was monitored for the development of a spondylolisthesis. Because of progression and exacerbation of symptoms, neurosurgical consultation for surgical stabilization was mandated.