Triple-Level Degenerative Spondylolisthesis and the Importance of Spinopelvic Parameters: Case Report

Abstract Background Lumbar degenerative spondylolisthesis typically occurs at a single vertebral level and infrequently at two separate levels. However, a triple level lumbar degenerative anterolisthesis is an extremely rare clinical scenario. The preservation or restoration of sagittal balance with the consideration of the observed spinopelvic parameters is of a cardinal importance in multilevel level DS than in single level DS. Presentation of the case: An evaluation of a middle-aged woman with persistent radiculopathy and neurogenic claudication revealed a three-level degenerative anterolisthesis from L3 to S1. With the placement of Iliac to L3 screw rod fixation in association with a decompressive laminectomy, a three-level interbody fusion and three level Smith Petersen osteotomies; a desirable lordosis and sagittal balance was preserved. She is ambulating well at a 9-month follow-up encounter. Conclusion Three level continuous degenerative anterior spondylolisthesis of the lumbar spine is a very rare clinical scenario being reported in only one previous instance throughout medical literature. The key initiative in the management of this condition is the preservation or correction of any sagittal imbalance present.