Early postoperative sacral fracture after short-segment posterior lumbar interbody fusion for L5/S1 isthmic spondylolisthesis: A case report

Toshinari Kawasaki; Motohiro Takayama; Yoshinori Maki; Tamaki Kobayashi; Yoshihiko Ioroi

doi:10.25259/SNI_189_2022

Early postoperative sacral fracture after short-segment posterior lumbar interbody fusion for L5/S1 isthmic spondylolisthesis: A case report

Surg Neurol Int. 2022 Apr 15:13:142. doi: 10.25259/SNI_189_2022. eCollection 2022.

Authors

Toshinari Kawasaki¹, Motohiro Takayama¹, Yoshinori Maki², Tamaki Kobayashi¹, Yoshihiko Ioroi¹

Affiliations

¹ Department of Neurosurgery, Otsu City Hospital.
² Department of Rehabilitation, Hikari Hospital, Shiga, Japan.

Abstract

Background: Early postoperative sacral fractures are extremely rare complications of single-level posterior lumbar interbody fusions (PLIFs).

Case description: A 71-year-old female presented with lower back pain and right S1 radiculopathy attributed to MR-documented L5/S1 isthmic spondylolisthesis. Following a L5 laminectomy and bilateral L5/S1 PLIF, she experienced sacral pain while sitting. When the MR showed a sacral insufficiency fracture with anterolisthesis at L5/S1, a secondary posterior fusion was extended to the pelvis, utilizing bilateral iliac screws. Following this reoperation, the patient did well and went on to achieve arthrodesis.

Conclusion: Early postoperative sacral fractures that occur following single-segment L5/S1 PLIF for isthmic spondylolisthesis warrant fusion to the pelvis with bilateral iliac screws.

Keywords: Iliac screws; Isthmic spondylolisthesis; Sacral fracture; Short-segment posterior lumbar interbody fusion.

Publication types

Case Reports