Congenital spondylolysis at the L5-S1 level complicated by severe disc disease and foraminal stenosis, along with a marked curvature of the sacrum.
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A 20-year-old woman.She had been complaining of lumbar and radicular symptoms for several years, with significant functional limitations.She had been undergoing analgesic treatment for years without an initial diagnosis.No clinical benefit was observed.Imaging studies revealed congenital spondylolysis at the L5-S1 level complicated by severe disc disease and foraminal stenosis, along with a marked curvature of the sacrum.Based on her clinical condition and the results of the imaging studies, surgical therapy was not recommended; instead, only manual physiotherapy was recommended.Her case came to my attention.Congenital listhesis complicated by severe disc disease should be treated surgically.The only therapeutic option is surgery; this is not a possibility, but a fact.My choice was certainly surgery, but with a separate anterior approach using an anchored cage. The decision to opt for an exclusively anterior approach was made due to the excessive anterior pelvic tilt and the very high rate of postoperative pain in the sacroiliac joint that I often experience following posterior arthrodesis.The return to a pain-free lifestyle, the resumption of physical activity, and careful physiotherapy rehabilitation currently reassure me about the surgical option.The follow-up is currently 8 months. The patient will be monitored over time.