Oblique lateral interbody fusion for severe lumbar spondylolisthesis after decompression surgery for spina bifida

Background

When treating lumbar spondylolisthesis after Laminectomy, the posterior approach was concerned about the risk of neuronal adhesions.

Case presentation

The case is a mid 20's man. Immediately after birth, the patient underwent an excision for the lumbosacral hemangiopericytoma at a previous hospital. At the age of 14, an L2-S1 laminectomy was performed for spina bifida. From the age of 26, low back pain, pain in both lower limbs and numbness increased. Intermittent claudication: 50 m, visual analogue scale (VAS) score (LBP):100 mm, VAS score (leg pain):50 mm, VAS score (leg numbness):100 mm. CT imaging revealed L4 spondylolisthesis (Meyerding Grade 2), and MRI showed L4/5 severe spinal canal stenosis. We performed L4/5 lumbar lateral interbody fusion (LLIF) and posterior fixation. LBP and numbness in both lower limbs disappeared, and he was able to walk independently.

Conclusions

LLIF safely enables indirect decompression and fusion without additional posterior direct decompression, and is useful for failed posterior spine fusion surgery, which is a high-risk case of nerve tissue adhesion.