2002 Volume 14 Issue 2 Pages 187-191
The patient in this case of spondyloptosis associated with dural ectasia in von Recklinghausen disease was a 15-year-old girl with a family history of the disease. In May 1999, she complained of pain in the lumbar and the left side gluteal regions. The straight leg rising test was positive at 60° for the left leg. The manual muscle test result was good at dorsal flexion of right first toe. No sensory abnormality was noted. She had a widening of the spinal canal from L4 to S1 with vertebral scalloping between the L3 and S1 levels, scoliosis (cobb angle 30°), and spondyloptosis (L5/S1) on radiographs and computer tomography and myelography. A magnetic resonance image showed a wide spinal canal, a normal cord, and dural ectasia in the lumbosacral area.
Treatment was successfully accomplished in August 2000 by a posterior spinal instrumentation from the T8 to the S1 level using the Galveston method followed by a posterolateral fusion and posterior lumbar interbody fusion (L5/S1). The preoperative Cobb angle was 30° and the postoperative angle was 9°. The patient had complete relief of lumbar and gluteal pain at the 18-month follow-up.
