Treatment of Spondylolisthesis Using a Motion Preserving Lumbar Total Joint Replacement: A Case Report

Abstract

Spinal fusion is the primary treatment option for symptomatic spondylolisthisis. Although effective in alleviating pain and restabilizing the spine, lumbar fusion is associated with long-term sequelae due to the elimination of a motion segment. Alternatives to lumbar fusion for the treatment of grade 1 spondylolsithesis have remained limited due to the complex anatomy, need for stabilization and neural elements. To our knowledge, there are no motion-preservation options that would allow the surgeon to perform a complete laminectomy, facetectomy and segment reconstruction in the setting of isthmic spondylolisthesis. Here we present the case of a 19-year-old female that received motion-preserving lumbar Total Joint Replacement (TJR) for a grade 1 isthmic spondylisthesis at L5-S1. Patient data, including radiographs, were prospectively collected. Two years after lumbar TJR, the patient’s ODI and NRS back and leg pain scores were all 0. Our patient was symptom free at two years follow up which demonstrates that lumbar joint replacement may be a motion-preserving option for similar patients.