Traumatic Lumbosacral Spondyloptosis in a Pediatric Patient: Case Report and Literature Review

Abstract

A 4-year-old girl was admitted to the emergency department after having been buried beneath a wall. A computed tomography scan revealed anterior grade V L5–S1 spondylolisthesis, and magnetic resonance imaging showed a traumatic rupture of the fibrous annulus of the L5–S1 intervertebral disc and lesion of the anterior longitudinal and yellow ligaments. The patient underwent anterior and posterior fixation. Four months later she was able to walk independently, despite a persistent left foot drop. Additionally, we conducted a literature review on lumbosacral spondyloptosis in the pediatric population published between 1990 and 2017. We found 16 cases, 86.6% of which were male, with a mean patient age of 16 ± 5.05 years. Most patients underwent spine instrumentation. Based on the data reviewed, the neurological status at admission might be a valid predictor of outcome. Pedicle screws are a safe and reliable procedure for stable fixation of the spine in these cases. The removal of screws is discouraged.

Case report: Traumatic lumbosacral spondyloptosis with locked L5 inferior articular process

“…In 2007, Vialle et al ( 12 ) proposed a more detailed classification method based on the injury of articular process and intervertebral disc. In our case, a bilateral facet fracture with rotational displacement associated with complete dislocation of L5 was found via MRI and CT scan; therefore, the patient belongs to type IIIB ( 13 – 15 ). According to the AOSpine Classification, lumbosacral spondyloptosis is categorized as a type C with severe biomechanical instability that requires surgical treatment.…”

Irreducible L5/S1 Spondyloptosis in Over 20 Years After Neglected Trauma Treated with Modified Grob’s Technique – Case Report

“…Spondyloptosis is typically the result of high-energy trauma and necessitates urgent surgical intervention, as delay in treatment may further exacerbate the condition. [4][5][6][7][8] It is uncommon for patients to present to a spinal surgery unit several decades after the initial traumatic event. In this context, we present a noteworthy case report of a patient who experienced sacrolumbar spine trauma over two decades ago and subsequently underwent surgical intervention involving spinal canal decompression and posterior lumbosacral fusion utilizing a modified Grob's method.…”