[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-455026-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-455026-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","posterior-deformity-correction-and-internal-fixation-for-sagittal-imbalance-due-to-spontaneous-fusion-in-lumbar-spondylolisthesis-a-case-report","Posterior deformity correction and internal fixation for sagittal imbalance due to spontaneous fusion in lumbar spondylolisthesis - A case report","","Lumbar spondylolisthesis with spontaneous fusion and accompanying sagittal imbalance creates complex surgical planning decisions. This case report describes a trauma-associated presentation in a 57-year-old patient with persistent low back pain despite standardized conservative care. Imaging revealed L4 anterolisthesis with bilateral pars interarticularis defects, progressive forward stooping (~40°), and worsening left lower-limb weakness. After failure of prolonged nonoperative management, pedicle screw instrumentation was performed without complications, followed by 3 days of bed rest and discharge on postoperative day 12. The report highlights diagnostic and strategy considerations when slipped-level symptoms are not solely attributable to the level.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/posterior-deformity-correction-and-internal-fixation-for-sagittal-imbalance-due-to-spontaneous-fusion-in-lumbar-spondylolisthesis-a-case-report/455026/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/posterior-deformity-correction-and-internal-fixation-for-sagittal-imbalance-due-to-spontaneous-fusion-in-lumbar-spondylolisthesis-a-case-report/455026.png","ImageObject",300,407,{"name":42,"@type":43},"Franzy","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-04","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What key problem does this case report address in surgical planning?","Question",{"text":63,"@type":64},"Lumbar spondylolisthesis with spontaneous fusion and sagittal imbalance is described as under-specified for decision-making, requiring evidence-informed surgical strategy selection.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What were the main symptoms and imaging findings in the reported patient?",{"text":68,"@type":64},"After trauma, the patient developed low back pain with L4 anterolisthesis and bilateral pars interarticularis defects on CT, with progressive forward stooping (~40°) and left lower-limb weakness.",{"name":70,"@type":61,"acceptedAnswer":71},"Why does the report suggest that symptoms may not always originate from the slipped level?",{"text":72,"@type":64},"When LS and SI coexist, symptoms are not invariably attributable to the slipped level; marked forward stooping may reflect issues such as ligamentum flavum hypertrophy, nerve-root entrapment, adhesions, or adjacent-level pathology.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},455026,1790800832,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":97,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144,"preview_page_count":4},2336478945519,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","®  \n Clinical Case Report   \nPosterior deformity correction and internal fixation for sagittal imbalance due to spontaneous fusion in lumbar spondylolisthesis  \nA case report  \nYuhai Yan, MMa , Changliang Ou, MDa , Xu Gao, MDa , Haozhu Chen, MDa , Kaiwei Zhang, MDb ,*  \n\n| Abstract\u003Cbr>Rationale: Lumbar spondylolisthesis (LS) with spontaneous fusion (SF) accompanied by sagittal imbalance (SI) poses a practical decision-making challenge in surgical planning. Here, we present a trauma-associated case of lumbar spondylolisthesis with SF and SI, and outline a reproducible, evidence-informed framework for surgical management.\u003Cbr>Patient concerns: A 57-year-old patient developed low back pain after trauma. Lumbar computed tomography (CT) showed L4 anterolisthesis with bilateral pars interarticularis defects. Despite standardized conservative treatment, the back pain progressed, with forward trunk inclination of approximately 40° and concomitant left lower-limb weakness.\u003Cbr>Diagnosis: Lumbar spondylolisthesis with nerve root impairment.\u003Cbr>Interventions: After over 20 years of conservative treatment, the symptoms did not achieve meaningful improvement; the patient’s back pain progressively worsened, with forward trunk inclination of approximately 40° and progressive weakness of the left lower limb. The patient ultimately underwent pedicle screw instrumentation.\u003Cbr>Outcomes: The procedure was uneventful; the patient remained on bed rest for 3 days and was discharged on postoperative day 12.\u003Cbr>Lessons: LS with SF and SI is encountered clinically but remains under-specified for surgical decision-making; importantly, when LS and SI coexist, symptoms are not invariably attributable to the slipped level – marked forward stooping may instead reflect ligamentum flavum hypertrophy, nerve-root entrapment, adhesions, or other adjacent-level pathology. In selected patients, LS with SI does not require reduction of the slipped vertebra; surgical objectives can be achieved by decompression of the symptomatic level(s) and restoration of segmental lordosis to re-establish global alignment.\u003Cbr>Abbreviations: CT = computed tomography, DR = digital radiography, ICU = intensive care unit, LL = lumbar lordosis, LS = lumbar spondylolisthesis, MRI = magnetic resonance imaging, PI = pelvic incidence, PI–LL = pelvic incidence minus lumbar lordosis, PT = pelvic tilt, SI = sagittal imbalance, SS = sacral slope, SVA = sagittal vertical axis, TK = thoracic kyphosis. |\n| --- |\n| Keywords: internal fixation, lumbar spondylolisthesis, sagittal imbalance, spontaneous fusion |\n\n1. Introduction  \nLS with spontaneous fusion (SF) and sagittal imbalance (SI) is encountered clinically but remains under-specified for surgical decision-making. It typically reflects intervertebral instability and disruption of sagittal alignment associated with LS. Patients may present with persistent low-back pain, radicular symptoms from nerve-root compression, and gait disturbance. [1,2] SF denotes gradual, nonoperative fusion at the slipped level driven by long-standing instability or local biomechanical changes; paradoxically, SF can coexist with or contribute to SI, further worsening global spinal biomechanics. [3]  \nThe pathogenesis remains incompletely understood; however, displacement at the slipped level and the development of SF may alter spinal load-bearing mechanics, precipitating SI. Particularly in older adults, disruption of sagittal alignment can result insubstantial neurological impairment and a marked decline in quality of life. [4,5] This report presents a patient with LS with SF and SI who, after prolonged conservative management without meaningful improvement, underwent corrective posterior instrumentation and fusion. Through this case, we discuss clinical diagnostic considerations and surgical strategy selection for this scenario and provide evidence to inform practice.  \nThe authors have no funding and conflicts of interest to disclose.  \nAll data generated or analyze","cbCainCKT7ZWBuUV","https://ap.wps.com/l/cbCainCKT7ZWBuUV","pdf",621279,"English","# Abstract\n## Rationale\n## Patient concerns\n## Diagnosis\n## Interventions\n## Outcomes\n## Lessons\n# Introduction","[{\"question\":\"What key problem does this case report address in surgical planning?\",\"answer\":\"Lumbar spondylolisthesis with spontaneous fusion and sagittal imbalance is described as under-specified for decision-making, requiring evidence-informed surgical strategy selection.\"},{\"question\":\"What were the main symptoms and imaging findings in the reported patient?\",\"answer\":\"After trauma, the patient developed low back pain with L4 anterolisthesis and bilateral pars interarticularis defects on CT, with progressive forward stooping (~40°) and left lower-limb weakness.\"},{\"question\":\"Why does the report suggest that symptoms may not always originate from the slipped level?\",\"answer\":\"When LS and SI coexist, symptoms are not invariably attributable to the slipped level; marked forward stooping may reflect issues such as ligamentum flavum hypertrophy, nerve-root entrapment, adhesions, or adjacent-level pathology.\"}]","Posterior deformity correction and internal fixation for sagittal imbalance due to spontaneous fusion in lumbar spondylolisthesis - A case report | PDF",1790741964,13]