Transsacral Screws in Combination With an Expandable Cage for High-Grade Spondylolisthesis: A Novel Technique...

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Fusion Techniques

Background:

• High-grade spondylolisthesis at L5/S1 poses surgical challenges due to instability and neural compression.
• Traditional fusion methods may require extended instrumentation or secondary procedures to restore mobility.
• Restoring lumbosacral alignment and achieving solid fusion in severe slips is complex.

Purpose of the Study:

• To describe a novel single-stage surgical technique for treating high-grade L5/S1 spondylolisthesis.
• To evaluate the efficacy and safety of transsacral screw fixation combined with an expandable interbody cage.
• To present a case demonstrating improved biomechanical stability and clinical outcomes.

Main Methods:

• A 19-year-old female with Meyerding grade III L5/S1 spondylolisthesis underwent laminectomy and L5 nerve root decompression.
• Transsacral screw fixation was combined with an expandable interbody cage in a single surgical stage.
• Postoperative assessment included clinical pain evaluation and radiographic analysis of fusion and alignment.

Main Results:

• The patient experienced significant relief from lumbar and sciatic pain post-surgery.
• Restoration of lumbosacral alignment and radiographic evidence of solid fusion were achieved at six months.
• No neurological deficits or implant-related complications were observed during the follow-up period.

Conclusions:

• The described single-stage technique using transsacral screws and an interbody cage offers a promising option for high-grade L5/S1 spondylolisthesis.
• This method provides enhanced biomechanical stability compared to previous approaches.
• Further studies with longer follow-up are warranted to confirm the long-term efficacy of this technique.