Spinal disassociation masquerading as iatrogenic listhesis above a previous fusion.

Publication/Presentation Date

3-15-2006

Abstract

STUDY DESIGN: A case of remarkable instability adjacent to an L5-S1 fusion is reported.

OBJECTIVES: The objective of this study was to review a case of marked instability adjacent to a prior fusion. Diagnostic workup and surgical management options are discussed.

SUMMARY OF BACKGROUND DATA: Junctional degeneration above or below the levels of a spinal fusion may be associated with instability. We present an unusual case of instability whose severity was only apparent when the patient was under general anesthesia.

MATERIALS AND METHODS: A 52-year-old man with a history of prior L5-S1 fusion presented with severe back pain and lower extremity weakness. Workup including multiple imaging methods revealed junctional degeneration and a Grade I spondylolisthesis at L4-L5 with minimal translation on dynamic imaging. Operative intervention was planned.

RESULTS: Intraoperative imaging revealed marked distraction at the L4-L5 disc space not apparent on preoperative dynamic films. The surgical approach was modified accordingly.

CONCLUSIONS: Adjacent segment degeneration next to a prior lumbar fusion may be associated with extreme instability. Treatment may require complex stabilization.

Volume

31

Issue

6

First Page

179

Last Page

183

ISSN

1528-1159

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

16540859

Department(s)

Administration and Leadership

Document Type

Article

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