Isthmic Spondylolisthesis


This is an active 35 year old female who presented with complaints of worsening lower back pain. On examination, her pain limited her range of motion and she had difficulty bending forwards and backwards.

She was followed for over 1 year while she took medication, underwent physical therapy, and pursued other non-operative treatment. Over a period of 12 months she began to experience persistent, unrelenting lower back pain, and complained of sporadic pain in her lower extremities that was at times debilitating.

Pre-treatment Images


The patient was diagnosed with a L5-S1 isthmic spondylolisthesis (grade 2) with moderate foraminal stenosis and compression of the exiting L5 nerve roots resulting in spinal instability.

Selected Treatment

The patient underwent an L5-S1 anterior lumbar interbody fusion (ALIF)
Her spine was approached from the front allowing for the placement of a larger implant, greater spinal stability, and better fusion.

Posterior minimally invasive instrumented fusion was also performed to ensure adequate stability.

Post-operative radiographs


The patient spent 2 nights in the hospital and returned to work 3 weeks after surgery. The pain in her legs resolved, and she has had no back pain since the procedure.