48 year woman with spondylolisthesis L4L5 with severe back pain. Previously operated for L5 S1 disc elsewhere 4 years ago

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There is spondylolisthesis of L5 upon S1, and not of L4 upon L5 as mentioned. Treatment should be spinal stabilization by posterior instrumentation after reduction of spondylolisthesis, otherwise, anterior body fusion of L5 & S1 is indicated.

There is laminectomy of L4 and L5 Get an MRI to assess cord and roots Show to a spine surgeon to plan pedicle screw fixation and fusion.

There appears to be sacralisation of L5 or maybe it is fused due to previous surgery. In any case there is grade two spondylolisthesis. Treatment is decompression and fusion. ideal would be a TLIF which would ensure not only good fusion but would also aid in reduction. If one is not too adept at TLIF, one can just carry out a Gill's procedure with instrumented posterolateral fusion.

Fusion with instrumentation was done. A female patient not male as written on x-ray. Post op pictures are shown

If she is fine neurologically then physio would be better option for her

Lumbar lordosis. Spinal Orthotics management may be helpful. Recommends LS corset or brace.

Now she requires MRI. The L4L5S1 should be fused after rducing the spondylolisthesis if possible.

Stretching exercise and strength exercise of spine Avoid heavy weight and towards bending. With physiotherapy treatment

Please post all the x-rays and MRI too (all views)

can't see post op images

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