“…In this case the authors were concerned about repetitive mechanical stress in a young and very active patient and therefore they chose a stronger construct. A more aggressive approach was implemented by Viswanathan et al [ 16 ] on a 41-year-old woman with low back and left-sided radicular pain affected by L4 pediculolysis, contralateral Spondylolysis and grade 1 spondylolisthesis and instability found on dynamic lateral radiographs. An L5-S1 arthrodesis was performed.…”