Bilateral Spondylolysis of Lumbar Vertebra Secondary to Long Spinal Fusion for Idiopathic Scoliosis: A Case Report and Review of Literature

Abstract

Background: Lumbar spondylolysis is a common cause of low back pain in adolescents. A lot of adolescent idiopathic scoliosis with concomitant spondylolysis has been reported before, but only two cases with acquired spondylolysis following long fusion for scoliosis were reported. We described another similar rare case and discussed its causes and treatment options in this paper.

Case Presentation: A 17-year-old female underwent growing rod implantation, growing rod extension, and final long spinal fusion for idiopathic scoliosis. Then, she suffered from low back pain with a VAS of 1-2 points and gradually aggravated to a VAS of 7-8 points at 3.5 years after the final fusion. The X-ray images showed that there was L4-S1 instability. And the CT scan images showed new bilateral spondylolysis of L5.

Conclusions: These findings suggested that distal mechanical stress might cause spondylolysis of the distal vertebra following long fusion for scoliosis. Surgeons should keep instrumentation as short as possible and avoid choosing a low lumbar as LIV when they decide on the fusion levels.

Keywords

Case Report / Idiopathic Scoliosis / Long Fusion / Spondylolysis

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2024 The Author(s). Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.