Long-Term Experience With Reduction Technique in High-Grade Spondylolisthesis in the Young

Distraction of the screws allows entry and insertion of pedicle screw into L5.

Sacral dome excision using an osteotome after L5 screw placement.

Figure 5. Reduction of listhesis through L5 reduction screws or use of reducers to bring the screw to the rod. Figure 6. L5/S1 interbody space distraction to further reduce the lumbosacral kyphosis.

Removal of temporary L2-3 screws and rod followed by compression of L5/S1 over an interbody device to give final construct which shows restored sagittal balance.

Image shows final construct with good reduction (spondyloptosis to grade I) and interbody fusion.

A case of 8-year-old girl with grade 4 spondylolisthesis who refused surgery, had slip progression in 4 years, and then underwent reduction and fusion. This is an example of our earliest case where fixation was extended to L4 and a Chopin plate system was used at the sacrum.

Eleven-year follow-up shows implants in good position, with no loss of reduction and maintenance of normal radiographic parameters.

A case example of a 10-year-old girl with spondyloptosis who underwent the reduction technique and posterior fusion.

Two-year follow-up images showing no loss of reduction with stable pelvic parameters. Concomitant scoliosis also corrected spontaneously by surgery.