Spinal Disorders: Fundamentals of Diagnosis and Treatment Part 75. Spinal disorders are among the most common medical conditions with significant impact on health related quality of life, use of health care resources and socio-economic costs. Spinal surgery is still one of the fastest growing areas in clinical medicine. | 734 Section Spinal Deformities and Malformations Thirty-six-year-old patient with developmental spondylolisthesis L5 S1 Meyer-ding Grade IV. The patient initially consulted a GP with low-back pain and was treated with a brace and further conservative measures moderately successfully over a period of 2 years. Sciatica the beginning of neurologic deficit in the form of numbness in the left leg as well as mild vesical incontinence on sneezing and coughing led to presentation in our clinic. Neurologic assessment conventional radiographs a and MRI b led to the diagnosis. Posterior lumbar interbody fusion PLIF with placement of two PEEK cages filled with autologous spongiosa was subsequently performed as a one-step procedure. An improvement of spinal realignment from Meyerding Grade IV to Meyerding Grade I-II c was achieved. Postoperatively the patient had a transitory L5 weakness which quickly improved and subsided completely after 10 days without revision surgery. One year after surgery realignment is still held and there is bony bridging between L5 and S1 d . Case Introduction Even high-grade spondylolisthesis can remain asymptomatic The incidence is 5-6 in males and 2-3 in females thesis. In comparison to their age group female adolescent gymnasts have a nearly four times increased probability of stress fractures of the pars interarticu-laris 40 . A further example is professional bowlers and cricket players who show stress lesions of the pars on the non-dominant side 84 . Because even severe forms of spondylolisthesis can clinically remain completely asymptomatic the true incidence of the condition in the general population remains a matter of speculation. For developmental spondylolisthesis most studies report rates of around 3 though depending on the ethnic group assessed significantly higher incidences of up to 50 have been reported 9 36 42 49 90 . The incidence of spondylolisthesis in adult white males is reported to be 5-6 and in females 2-3 86 . According to .
