Published online Jun 16, 2021. doi: 10.12998/wjcc.v9.i17.4408
Peer-review started: February 2, 2021
First decision: March 25, 2021
Revised: March 27, 2021
Accepted: April 7, 2021
Article in press: April 7, 2021
Published online: June 16, 2021
Processing time: 112 Days and 19.9 Hours
Four-level lumbar spondylolysis is extremely rare. So far, only 1 case has been reported in the literature.
A 19-year-old man presented with severe back pain irresponsive to conservative therapies for 2 years. Lumbar radiographs and two-dimensional computed tomography scan showed four segment lumbar spondylolysis on both sides of L2-L5. Lumbar magnetic resonance imaging showed normal signal in all lumbar discs. Because daily activities were severely limited, surgery was recommended for the case. The patient underwent four-level bilateral isthmic repair at L2-L5. During surgery, L2-L5 isthmi were curetted bilaterally, freshened, and then grafted with autologous iliac bone that was bridged and compressed with a pedicular screw connected to a sub-laminar hook by a short rod. The symptoms of back pain almost disappeared. He has been followed-up for 96 mo, and his symptoms have never recurred. Fusion was found in all repaired isthmi 14 mo after surgery according to evaluation of lumbar radiography and computed tomography scan.
We report here 1 case of four-level lumbar spondylolysis that was treated successfully with direct isthmic repair.
Core Tip: Four-level lumbar spondylolysis is extremely rare. So far, only 1 case has reported in the literature. In the present study, we report 1 case of four-level lumbar spondylolysis that was treated successfully with direct isthmic repair.