Scoliosis Associated with Lumbar Spondylolisthesis: Spontaneous Resolution and Seven-Year Follow-Up

Abstract

Scoliosis is defined as a structural deformity of the spine in all three dimensions and diagnosed if the Cobb angle is ≥10 degrees. Scoliosis is frequently associated with symptomatic spondylolisthesis, with an incidence ranging from 15% to 48%. The present report describes a patient with scoliosis associated with grade IV lumbar dysplastic spondylolisthesis who experienced the spontaneous correction of scoliosis after spondylolisthesis correction and fixation. The patient was a 12-year-old girl premenarche with an eight-month history of progressively increasing scoliosis, including back pain, left side leg pain, spinal deformity, and abnormal gait. She had been treated with a brace at the referring hospital but without significant improvement. Anteroposterior radiographs showed a long section of the spine, from T2 to L2, curving about 28.8 degrees to her right side, without evident pedicle rotation. Lateral radiographs revealed L5/S1 dysplastic type spondylolisthesis with >75% slippage (Meyerding Grade IV), a dome-shaped sacrum, and a flat back with butterfly sign. Correction of her spondylolisthesis by segmental instrumentation and interbody fusion of L5 and S1 resulted in almost complete resolution of her pain and scoliosis, with the outcome remaining stable seven years after surgery. These findings indicate that patients with scoliosis caused by spondylolisthesis may require only surgery for the latter condition, avoiding unnecessary surgery for scoliosis.