46 A 52-year-old woman complained of chronic mechanical low back pain radiating to the thighs. On examination, sensation was decreased in the L5 distribution bilaterally. She had limited lumbosacral extension, with some paraspinous muscle spasm, and negative straight leg raises. Also, she had grade II spondylolisthesis at L5-S1 on lumbar x-ray. A postoperative x-ray demonstrates transpedicular screws and rods at L4, L5, and S1, with a T-piece fusion mass (Fig. 46-1). High-grade spondylolisthesis A 270-degree fusion, with L4-S1 decompression, pedicle screw fixation, and arthrodesis was performed.
High-Grade Spondylolisthesis
Presentation
Radiologic Findings
Diagnosis
Treatment
Discussion
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