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Título

SURGICALAPPROACH TO SPONDYLOLISTHESIS THROUGH LATERAL LUMBAR INTERBODY FUSION IN SINGLE POSITION: A CASE REPORT.

Introdução

Low back pain is considered the second leading cause of painful disorders that lead patients to seek medical help. One of the causes of low back pain is degenerative lumbar spondylolisthesis resulting from the progressive slippage of one vertebra over another with instability at the site. Surgical intervention with arthrodesis and/or decompression is the surgical treatment of spondylolisthesis and is recommended in cases where a conservative approach is not enough, for this reason, minimally invasive techniques such as Lateral lumbar interbody fusion (LLIF) can be used to focus on better patient prognosis.

Relato de caso

Male, 44 years old, without comorbidities, previously healthy, with a history of lower back pain with bilateral irradiation to the lower limbs (bilateral root L4 territory topography) since 2018, and undergoing previous magnetic resonance (Figure 05) which showed spondylolysis and lysis of bilateral pairs L4-L5, which evolved into lysis of the same segment. He had 9 points on the Visual Analog Scale (VAS) and the Index of Oswestry was 35%, revealing moderate disability.

The patient was refractory to conservative treatment with physiotherapy, pilates, infiltration and use of opioids and anti-inflammatory drugs.

On physical examination, he was in good general condition, with no motor deficiencies, but with the presence of severe pain in the lumbar region that radiated to both lower limbs. The Lasègue test was 30º bilaterally positive with irradiation to L4 root topography.

There was a worsening of pain in the extension and flexion movements of the trunk. In his personal history, he denied that he suffered from alcoholism, smoking, allergies, a history of trauma or a sedentary lifestyle.

The patient progressed without complications during the postoperative period and showed Improvement in the lower back pain. He was discharged from the hospital within 24 hours. He undertook physiotherapy sessions which helped during his post-operative rehabilitation.

Conclusão

The case reported bring to light the discussion around the therapeutic approach, which is innovative and has shown to have good results when compared to methods which had previously been considered to be the gold standard.

Furthermore, this approach has a lower complication rate, shorter surgical time, and anesthetic exposure, and with earlier recovery rates. It can also be concluded that during the preparation of this article, the paucity of literature addressing, in particular, this surgical update was noted, and this exposes the need for investments in studies on this topic to collaborate with the advancement of the scientific community and improvement of the LLIF technique.

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