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CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(04): 692-694
DOI: 10.4103/ajns.AJNS_63_21
Original Article

Minimally invasive surgery for traumatic high-grade lateral spondylolisthesis of L1 with multiple spinal fractures: Closed reduction and internal fixation using percutaneous pedicle screws

Takeshi Sasagawa
Department of Orthopedics Surgery, Toyama Prefectural Central Hospital, Toyama, Japan
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Background: Traumatic high grade lateral spondylolisthesis at the thoracolumbar junction is an extremely severe injury caused by high-energy trauma, commonly resulting in polytrauma. The treatment of this pathology is challenging, and even death following surgery has been reported. Therefore, it is necessary to focus on making surgical invasion minimal. Methods: A 53-year-old female fell from a height and presented with severe back pain and complete paralysis below L1. Computed tomography (CT) showed a Grade 4 traumatic lateral spondylolisthesis and severe comminution of L1, and mild compression fractures at T9 and L3. Results: First, we performed posterior surgery on the day of the injury to reduce the fracture and stabilize the spinal column using percutaneous pedicle screws (PPS). Twelve days later we resected the L1 vertebral body and inserted a cage with an iliac bone graft using an anterior approach. The estimated blood loss from posterior and anterior surgeries was 320ml and 200ml, respectively. Bony fusion was achieved as seen on CT at the 1-year follow-up. Conclusion: A 2-stage combined posterior-anterior approach using PPS can be performed less invasively, enabling adequate reduction, internal fixation, and anterior reconstruction for patients with high grade traumatic lateral spondylolisthesis without spinal shortening or facet interlocking.

Key-words:

Combined posterior–anterior approach - lateral spondylolisthesis - minimally invasive surgery - percutaneous pedicle screws - thoracolumbar fracture

Financial support and sponsorship

Nil.




Publikationsverlauf

Eingereicht: 12. März 2021

Angenommen: 04. Mai 2021

Artikel online veröffentlicht:
16. August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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