PMC9062948_01
Anteroposterior (a) and lateral (b) radiographs of the lumbar spine before lumbosacral fusion demonstrated isthmic spondylolisthesis at L5/S1 with mild scoliosis. T1- (c) and T2-weighted images (d) showed isthmic spondylolisthesis of L5 on S1.
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F1
A 71-year-old female with low back pain and right lower extremity sciatica had initial MR and CT studies that revealed L5/S1 isthmic spondylolisthesis (near Grade 3) and a Cobb's angle of 19.3  [Figure 1a-d]. One month postoperatively, X-rays, CT, and MRI examinations confirmed fusion, and the patient was now asymptomatic [Figure 4, Tables 1, 2].
Anteroposterior (a) and lateral (b) radiographs of the lumbar spine after lumbosacral fusion showed improvement of the L5/ S1 spondylolisthesis. T1- (c) and T2-weighted images (d) indicated the sacral fracture (white arrows) 3 weeks after the lumbosacral fusion.
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F2
One day postoperative lumbar X-rays/CT studies, and the MRI obtained at 1 postoperative week, documented resolution of the L5/S1 isthmic spondylolisthesis [Figure 2a and b]. By the 3rd postoperative week, X-rays and MRI studies showed a sacral insufficiency fracture, with instability above the sacral fracture, and anterolisthesis of S1 [Figure 2c and d, Figure 3]. One month postoperatively, X-rays, CT, and MRI examinations confirmed fusion, and the patient was now asymptomatic [Figure 4, Tables 1, 2].
Lateral radiographs of the lumbar spine in the sitting (a) and supine positions (b) after lumbosacral fusion showing instability at the S1/S2 level.
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F3
By the 3rd postoperative week, X-rays and MRI studies showed a sacral insufficiency fracture, with instability above the sacral fracture, and anterolisthesis of S1 [Figure 2c and d, Figure 3].
Postoperative anteroposterior (a) and lateral (b) radiographs of the lumbar spine following the lumbopelvic fusion.
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F4
One month postoperatively, X-rays, CT, and MRI examinations confirmed fusion, and the patient was now asymptomatic [Figure 4, Tables 1, 2].