Unusual Pattern of Traumatic Anterolisthesis at Multiple Levels (L3,4,5 Over S1) Because of Pedicle Avulsion

A Case Report

Abstract

Case: 

Multilevel lumbar spondylolistheses have been reported, but only secondary to degenerative processes. We describe a case where grade 4 anterolisthesis occurred (L3,4,5 over S1) because of multiple level traumatic pedicle avulsion rather than facetal/pars interarticularis/posterior ligamentous complex disruption in a 42-year-old man who presented with paraparesis after a fall from height. Decompression was performed at the L5 level, and pedicle screw fixation was performed at L3, L5, and S1 levels.

Conclusion: 

Although such an injury pattern seems catastrophic, it is deemed relatively stable because of the intact posterior ligamentous complex. Restoration of anatomy with stabilization allowed early mobility and satisfactory neurological recovery.