Case Report
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Clin Cases. Jun 16, 2013; 1(3): 116-120
Published online Jun 16, 2013. doi: 10.12998/wjcc.v1.i3.116
Trans-sacral screw fixation in the treatment of high dyplastic developmental spondylolisthesis
Alessandro Landi, Nicola Marotta, Cristina Mancarella, Roberto Tarantino, Roberto Delfini
Alessandro Landi, Nicola Marotta, Cristina Mancarella, Roberto Tarantino, Roberto Delfini, Department of Neurology and Psychiatry, Division of Neurosurgery, University of Rome “Sapienza”, 00165 Rome, Italy
Author contributions: The work was carried out in collaboration between all authors; Landi A, Marotta N and Defini R defined the research theme andperformed surgery; Mancarella C contributed to acquisition of data, interpretation of results and wreote the paper; Tarantino R co-worked on interpretation of data; all authors have contributed to, seen and approved the manuscript.
Correspondence to: Alessandro Landi, MD, PhD, Department of Neurology and Psychiatry, Division of Neurosurgery, University of Rome “Sapienza”, viale del Policlinico 155, 00165 Rome, Italy. dott.alessandro.landi@gmail.com
Telephone: +39-329-641772 Fax: +39-649-979105
Received: March 15, 2013
Revised: April 28, 2013
Accepted: May 18, 2013
Published online: June 16, 2013
Processing time: 90 Days and 22.1 Hours
Abstract

We describe the case of a 67-year-old woman with L5-S1 ontogenetic spondylolisthesis treated with pedicle fixation associated with interbody arthrodesis performed with S1-L5 trans-sacral screwing according to the technique of Bartolozzi. The procedure was followed by a wide decompressive laminectomy. The patient had a progressive improvement of the symptoms which gradually disappeared in 12 mo. The radiograph at 6 and 12 mo showed complete fusion system. The choice of treatment in L5-S1 ontogenetic spondylolithesis is related to a correct clinical and diagnostic planning (X-ray, computer tomography magnetic resonance imaging, Measurement). In particular, the severity index and the square of unstable zone, and the standard measurements already described in the literature, are important to understand and to plane the correct surgical strategy, that require, in most of the times, fusion and interbody artrodesis.

Keywords: High-dysplastic developmental spondylolisthesis; Spondylolisthesis; Trans-sacral screw; Pelvic balance; Spinopelvic imbalance

Core tip: The choice of treatment in L5-S1 ontogenetic spondylolithesis is related to a correct clinical and diagnostic planning (X-ray, computer tomography, magnetic resonance imaging, measurement). In particular, the severity index and the square of unstable zone, and the standard measurements already described in the literature, are important to understand and to plane the correct surgical strategy, that require, in most of the times, fusion and interbody artrodesis.