Dysplastic L5-S1 Spondyloptosis in a 3-Year-Old Child: A Case Report and Review of the Literature

Table 1

Literature review regarding management of L5-S1 spondyloptosis in preschool children (3–5 years).

Authors	Number of cases	Age (year)/sex	Management
Wild et al. [21]	1	5 yr/male	During initial surgery three-stage procedure (back-front-back). L5 lamina resection and wide L5 nerve root decompression, anterior subtotal resection of inferior L5 body with interbody morcellized vertebral body graft between L5 and S1, and finally posterior instrumentation (L2-S1) with reduction of L5-S1 spondyloptosis.; Subsequently after about 8 months, posterior instrumentation was removed; decortication of superior articular facets and both transverse processes of L5 vertebrae was done. Autogenous bone graft from iliac crest was taken and inserted to augment previous fusion.
Our case	1	3 yr/female	Wide posterior decompression followed by 5.5 mm pedicle instrumentation from L3-S2 vertebrae including bilateral 5.5 mm polyaxial reduction screw for L5 vertebrae and spondyloptosis reduction via rotation translation technique. Subsequently inner nuts of bilateral L3, L4, and S2 pedicle screws were kept loose and no interbody graft was used.; Finally following implant loosening after about >3-year follow-up, posterior instrumentation was revised with 6.5 mm polyaxial pedicle screws at L5 and S1 levels. Same stage anterior interbody L5-S1 fusion by transperitoneal approach.