OBJECTIVE: The purpose of this case study is to describe the diagnostic imaging studies of a patient who had a traumatic spondylolisthesis at L5-S1 secondary to unilateral facet fractures. CLINICAL FEATURES: A 21-year-old man experienced a rollover motor vehicle crash that led to low back pain and progressive left-sided radiculopathy. Later, he sought treatment from a doctor of chiropractic because he continued to have low back pain with progressive pain down his left leg. A magnetic resonance imaging study demonstrated a left paracentral disc protrusion at L5-S1. Follow-up computed tomography demonstrated multiple transverse process fractures and left-sided L5-S1 facet fractures with spondylolisthesis that progressed over time. INTERVENTION AND OUTCOME: The patient was referred for a neurosurgical consultation 10 months after the injury. At 12 months after the injury, he underwent transforaminal lumbar interbody fusion with a posterior approach. The patient's pain and radicular symptoms resolved after the surgery. CONCLUSION: This patient exhibited posterior element fractures, had continued symptom progression, and was monitored for the development of a spondylolisthesis. Because of progression and exacerbation of symptoms, neurosurgical consultation for surgical stabilization was mandated.
OBJECTIVE: The purpose of this case study is to describe the diagnostic imaging studies of a patient who had a traumatic spondylolisthesis at L5-S1 secondary to unilateral facet fractures. CLINICAL FEATURES: A 21-year-old man experienced a rollover motor vehicle crash that led to low back pain and progressive left-sided radiculopathy. Later, he sought treatment from a doctor of chiropractic because he continued to have low back pain with progressive pain down his left leg. A magnetic resonance imaging study demonstrated a left paracentral disc protrusion at L5-S1. Follow-up computed tomography demonstrated multiple transverse process fractures and left-sided L5-S1 facet fractures with spondylolisthesis that progressed over time. INTERVENTION AND OUTCOME: The patient was referred for a neurosurgical consultation 10 months after the injury. At 12 months after the injury, he underwent transforaminal lumbar interbody fusion with a posterior approach. The patient's pain and radicular symptoms resolved after the surgery. CONCLUSION: This patient exhibited posterior element fractures, had continued symptom progression, and was monitored for the development of a spondylolisthesis. Because of progression and exacerbation of symptoms, neurosurgical consultation for surgical stabilization was mandated.
Entities:
Keywords:
Low Back Pain; Spinal Fractures; Spondylolisthesis
Authors: James N Weinstein; Jon D Lurie; Tor D Tosteson; Brett Hanscom; Anna N A Tosteson; Emily A Blood; Nancy J O Birkmeyer; Alan S Hilibrand; Harry Herkowitz; Frank P Cammisa; Todd J Albert; Sanford E Emery; Lawrence G Lenke; William A Abdu; Michael Longley; Thomas J Errico; Serena S Hu Journal: N Engl J Med Date: 2007-05-31 Impact factor: 91.245
Authors: Athanasios I Tsirikos; Asif Saifuddin; M Hilali Noordeen; Stewart K Tucker Journal: Spine (Phila Pa 1976) Date: 2004-04-15 Impact factor: 3.468