Spondylolisthesis L4/5 â clinical and biomechanical case study

A patient of 68 with spondylolisthesis L4/5 level I, with chronic pain and severe deterioration of the neurological state (VAS 7, ODI 64%, and evaluated on Lovett scale), with diagnosed visible elongation of the vertebrae L4 by 13,8% and spondylolysis, was surgically treated. Intraoperatively, we removed the separated arc L4, carrying out simultaneously distraction and reposition of the slip devided by repositioning pivot RepoPLIF/DERO (“SLIDER”), following the new DrRB method (Distraction by rotation, Reposition & Blockage). Due to severe degeneration of the slip zone, beside the blockade preventing before a second slip by means of the RepoPLIF pivot anchored with teeth to the neighbouring vertebrae, in order to reduce the risk of second slip occurrence and prevent the setting, we applied transpedicular stabilization on 4 screws. Two months after the surgery, the patient’s condition improved significantly (VAS 1, ODI 46%). The removed arc L4 underwent detailed morphometric evaluation. Following the pre, intra and post-operative analyses, we stated that the deterioration of the patient’s state before the surgery was due not only to the occurrence of slip with isthmus, but also to rapidly progressing spine degeneration.