Scoliosis Associated with Lumbar Spondylolisthesis: Spontaneous Resolution and Seven-Year Follow-Up

Abstract

Scoliosis is defined as a structural deformity of the spine in all three dimensions and diagnosed if the Cobb angle is ≥10 degrees. Scoliosis is frequently associated with symptomatic spondylolisthesis, with an incidence ranging from 15% to 48%. The present report describes a patient with scoliosis associated with grade IV lumbar dysplastic spondylolisthesis who experienced the spontaneous correction of scoliosis after spondylolisthesis correction and fixation. The patient was a 12-year-old girl premenarche with an eight-month history of progressively increasing scoliosis, including back pain, left side leg pain, spinal deformity, and abnormal gait. She had been treated with a brace at the referring hospital but without significant improvement. Anteroposterior radiographs showed a long section of the spine, from T2 to L2, curving about 28.8 degrees to her right side, without evident pedicle rotation. Lateral radiographs revealed L5/S1 dysplastic type spondylolisthesis with >75% slippage (Meyerding Grade IV), a dome-shaped sacrum, and a flat back with butterfly sign. Correction of her spondylolisthesis by segmental instrumentation and interbody fusion of L5 and S1 resulted in almost complete resolution of her pain and scoliosis, with the outcome remaining stable seven years after surgery. These findings indicate that patients with scoliosis caused by spondylolisthesis may require only surgery for the latter condition, avoiding unnecessary surgery for scoliosis.

Scoliosis in dysplastic spondylolisthesis: a clinical survey of 50 young patients

“…A: Preoperative radiograph demonstrated obvious trunk tilt and vertebral rotation at the thoracolumbar spine; we believe the scoliosis was composed of idiopathic scoliosis and spondylolisthesis-induced scoliosis (54°). B: Postoperative radiograph at two-year follow-up shows relief of spondylolisthesis-induced scoliosis with normal coronal balance, while the idiopathic scoliosis was restored to its "original" shape (43°) accompanied by a large Cobb angle (20° or more), which can be confused with idiopathic scoliosis [10,12,[16][17][18][19][20]. It is important to distinguish the two cases, because the former can be relieved with reduction and fixation of the slip while the latter cannot.…”

“…It is important to distinguish the two cases, because the former can be relieved with reduction and fixation of the slip while the latter cannot. Several authors have reported complete resolution of severe scoliosis associated with spondylolisthesis after operative treatment of spondylolisthesis (Table 5) [17][18][19][20]. The scoliosis in these cases, with almost no vertebral rotation but large Cobb angle and marked coronal imbalance, should be considered as spasm scoliosis.…”

Clinical Efficacy of Unilateral Dual‐channel Endoscopic Lumbar Interbody Fusion for Lumbar Spondylolisthesis with Spinal Scoliosis

“…3 Scoliosis and spondylolisthesis are complex conditions that can be grouped into three main categories: idiopathic, radicular, and olisthetic. 4,5 Khashab et al 6 found that for patients with scoliosis caused by spondylolisthesis, surgery may only be needed for the latter condition, greatly improving symptoms and spinal curvature and avoiding unnecessary scoliosis surgery. In the treatment of L5 spondylolisthesis with accompanying scoliosis, Du et al 7 achieved a satisfactory reduction of slippage and correction of spinal curvature through transforaminal lumbar interbody fusion (TLIF).…”

“…Scoliosis and spondylolisthesis are complex conditions that can be grouped into three main categories: idiopathic, radicular, and olisthetic 4,5 . Khashab et al 6 . found that for patients with scoliosis caused by spondylolisthesis, surgery may only be needed for the latter condition, greatly improving symptoms and spinal curvature and avoiding unnecessary scoliosis surgery.…”

“… 4 , 5 Khashab et al . 6 found that for patients with scoliosis caused by spondylolisthesis, surgery may only be needed for the latter condition, greatly improving symptoms and spinal curvature and avoiding unnecessary scoliosis surgery. In the treatment of L5 spondylolisthesis with accompanying scoliosis, Du et al .…”