Rajendra Thakre Kunwar, Issac Thomas, Swamy B Mallikarjuna
Department of Orthopaedics, St. John's Medical College and Hospital, Bengaluru, Karnataka, India.
J Orthop Case Rep. 2015 Jul-Sep;5(3):90-1. doi: 10.13107/jocr.2250-0685.320.
Degenerative spondylolisthesis (DS) is usually seen at L4-L5 level and less frequently at L5-S1 level. This is a rare case report of spondylolisthesis of S1 over S2 with lumbarization of S1. Lumbarization of S1 is seen in just 1-2% of the population and to have spondylolisthesis in this segment is even rarer. The purpose is to report a rare case of DS at S1-S2 level.
This is a single case report of a 66-year-old gentleman who presented with complains of lower backache for 2 years and acute retention of urine to the emergency department. Detailed clinical and radiological evaluation of the spine was done which revealed lumbarization of S1 with spondylolisthesis at S1-S2 and facetal hypertrophy at L5, S1, and S2. He underwent decompression and stabilization at L5, S1, and S2 along with placement of autologous bone graft. The bladder symptoms disappeared after 3 weeks. At 1-year follow-up, patient's clinical symptoms were relieved, and he improved clinically.
To the best of our knowledge, this is probably the first case of DS of sacral vertebrae to be reported in English literature. The prevalence of complete lumbarization is around 1.8% and to get spondylolisthesis in this segment is even rarer, hence the lack of literature in this regard. Since this is the first of its kind of case, further case series or longitudinal studies of such cases may help understand better the pathomechanics related to spondylolisthesis at this level.
退行性腰椎滑脱(DS)通常发生在L4-L5节段,较少见于L5-S1节段。本文报告一例罕见的S1相对于S2椎体发生腰椎滑脱且伴有S1腰椎化的病例。S1腰椎化在人群中的发生率仅为1%-2%,而该节段发生腰椎滑脱则更为罕见。目的是报告一例罕见的S1-S2节段DS病例。
本文为一例66岁男性的单病例报告,该患者因下背痛2年并出现急性尿潴留而就诊于急诊科。对脊柱进行了详细的临床和影像学评估,结果显示S1腰椎化,S1-S2节段腰椎滑脱,L5、S1和S2节段小关节肥大。患者接受了L5、S1和S2节段的减压和固定手术,并植入了自体骨移植。3周后膀胱症状消失。随访1年时,患者的临床症状得到缓解,临床状况有所改善。
据我们所知,这可能是英文文献中报道的首例骶椎DS病例。完全腰椎化的发生率约为1.8%,而该节段发生腰椎滑脱更为罕见,因此这方面的文献较少。由于这是首例此类病例,进一步的病例系列研究或对这类病例的纵向研究可能有助于更好地理解该水平腰椎滑脱相关的病理力学机制。