Spontaneous resolution of scoliosis associated with lumbar spondylolisthesis.

BACKGROUND CONTEXT: Scoliosis in association with spondylolisthesis is a common phenomenon. According to the traditional opinion, scoliosis should be managed depending on its classification and flexibility. Recently, Crostelli and Mazza proposed a new opinion toward this topic. They advocate that spondylolisthesis-associated scoliosis, especially severe scoliosis, should be considered as idiopathic scoliosis and must be treated with the same principles used in the treatment of idiopathic scoliosis. According to their viewpoints, more scoliotic curves in association with spondylolisthesis need to be treated, either surgically or conservatively.

PURPOSE: To describe the spontaneous correction of a severe case of scoliosis by internal fixation of the spondylolisthesis.

STUDY

DESIGN

Case report of a patient with scoliosis developing in association with high-grade lumbar spondylolisthesis.

METHODS

A 12-year-old girl presented with a 2-year history of spinal curvature. She did not have low back or leg pain. The scoliotic deformity corrected readily in the supine position. Radiographs revealed 88% slippage of L5 on S1 in addition to a long section curve of the spine with the main 50° curve at the thoracic level. The spondylolisthesis was repaired with segmental instrumentation and circumferential fusion of L5 and S1.

RESULTS

The scoliosis showed spontaneous resolution gradually after lumbosacral fusion and reached a complete correction 2 years after surgery.

CONCLUSIONS

The relationship between scoliosis and spondylolisthesis is complex. If scoliosis is considered to be caused by spondylolisthesis, surgery for the latter condition might be the only required intervention for the patient. Unnecessary operation for scoliosis should be avoided.