Clin Orthop Surg.  2015 Sep;7(3):410-413. 10.4055/cios.2015.7.3.410.

Multilevel Thoracolumbar Spondylolysis with Spondylolisthesis at L4 on L5

• Kim WJ
• Song YD
• Choy WS

• KMID: 2234100
• DOI: http://doi.org/10.4055/cios.2015.7.3.410

Abstract

A 24-year-old male patient was initially evaluated for persistent back pain. The visual analogue scale (VAS) score was 7 points. Physical examination revealed a decreased range of lumbar spinal motion, which caused pain. Simple X-ray revealed Meyerding grade 1 spondylolisthesis at L4 on L5, with mild dome-shaped superior endplate and consecutive multilevel spondylolysis at T12-L5. Standing anteroposterior and lateral views of the entire spine revealed normal balance of sagittal and coronal alignment. A computed tomography scan revealed bilateral spondylolysis at T12-L4, left unilateral spondylolysis at L5, and spina bifida at L5 to sacral region. Magnetic resonance imaging revealed mild dural ectasia at the lumbar region. Due to the absence of any neurological symptoms, the patient was managed conservatively. He was rested a few weeks with corset brace and physiotherapy. After treatment, his back pain improved, VAS score changed from 7 to 2, and he was able to return to normal activity.

Keyword

Spondylolysis; Dura pathology; Spina bifida

MeSH Terms

Adult
Back Pain/etiology
Humans
*Lumbar Vertebrae/pathology/radiography
Magnetic Resonance Imaging
Male
*Spinal Dysraphism
*Spondylolisthesis/pathology/radiography
*Spondylolysis/pathology/radiography
*Thoracic Vertebrae/pathology/radiography
Young Adult

Figure

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  Fig. 1 Radiographs of the lumbar spine showing multilevel spondylolysis.

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  Fig. 2 Whole standing spine X-rays showing normal sagittal and coronal balance.

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  Fig. 3 Three-dimensional reconstruction of computed tomography scan showing spina bifida at L5 to sacral region.

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  Fig. 4 T2-weighted magnetic resonance imaging revealing mild dural ectasia at lower lumbar region.

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