Spondylolysis-induced Multilevel Lumbar Spondylolisthesis; Challenges in Lumbar Spine Surgery

Lumbar spondylolysis and multilevel lumbar spondylolysis account for 4.4-5.8% and 0.3% of the general population, and multilevel lumbar spondylolysis resulting in spondylolisthesis is even rarer. Herein, we report two cases of three-level lumbar spondylolisthesis because of spondylolysis: A 49-year-old woman was admitted to the hospital for dull lower back pain over the past 8 months, with exacerbating symptoms when standing and walking. Spasticity at lumbar region and radiculopathy at S1 nerve root was found on examination and a 63-year-old man was admitted to the hospital because of numbness and perianal sensory disturbances with difficulty urinating 2 weeks ago, the symptoms gradually increased to the time of examination. Both patients were diagnosed with multilevel lumbar spondylolisthesis because of spondylolysis and were indicated for posterior lumbar interbody fusion (PLIF). After surgery, both patients recovered well without any significant complications. The improved treatment results suggest the application of PLIF technique to treat spondylolysis-induced multilevel lumbar spondylolisthesis.Keywords: Multilevel lumbar spondylolisthesis; Low back pain; Nerve root pain; Spondylolysis; Posterior lumbar interbody fusion (PLIF).