Lumbosacral spondyloptosis treated using partial reduction and pedicular transvertebral screw fixation in an osteoporotic elderly patient

Case report

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Spondyloptosis is complete dislocation of the L-5 vertebral body on the sacrum anteriorly. Its optimal treatment is still controversial. In particular, choosing the optimal surgical technique is difficult in the osteoporotic elderly patient given the high incidence of instrumentation failure, pseudarthrosis, progressive slippage, and severe sagittal imbalance. The authors of this report used partial reduction and pedicular transvertebral screw fixation of the lumbosacral junction for the treatment of spondyloptosis in an osteoporotic elderly patient.

Article Information

Address correspondence to: Eun-Min Seo, M.D., Department of Orthopedic Surgery, Chuncheon Sacred Heart Hospital, #153, Kyodong, Chuncheon, Kangwon-do, 200-704, Korea. email:

Please include this information when citing this paper: published online November 25, 2011; DOI: 10.3171/2011.10.SPINE11161.

© AANS, except where prohibited by US copyright law.



  • View in gallery

    Standing lumbosacral lateral radiographs showing severe sagittal imbalance (left) and L5–S1 Grade V spondylolisthesis (right).

  • View in gallery

    Lumbosacral CT scan (left) showing bilateral discontinuity of the pars interarticularis. Sagittal T2-weighted MR image (right) demonstrating severe spinal canal stenosis at the L5–S1 level due to slippage.

  • View in gallery

    Postoperative lumbosacral anteroposterior (left) and lateral (right) radiographs showing pedicular transvertebral screw fixation of the lumbosacral junction and additional anterior lumbar interbody fusion.

  • View in gallery

    Sagittal CT scan (left) obtained at the 10-month follow-up, showing partial reduction and interbody bony union between L-5 and S-1. Standing lumbosacral lateral radiograph (inset) and photograph (right) showing improvement in sagittal balance and fully upright standing posture of the patient.



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