OBJECTIVE: The English literature describes no pediatric cases of reduction of high-grade spondylolisthesis using the transvertebral surgical approach. We report a case of a high-grade spondylolisthesis in a child and provide a review. The aim of this study was to determine the efficacy of a specific reduction with the transvertebral surgical approach to treat patients with high-grade spondylolisthesis where there is loss of sagittal balance, intractable pain, and/or a neurological deficit.

METHODS: The patient was a 11-year-old girl who presented with recurrent back pain, urinary incontinence, and bilateral leg pain due to L5-S1 high-grade spondylolisthesis. The pre-and postoperative neurological status was evaluated and radiographic films were reviewed. RESULTS: She was treated by total L-5 laminectomy with foraminotomy and posterior fusion through the transvertebral approach. The lumbosacral dislocation was partially reducted. The percent slip and slip angle were measured pre- and postoperatively. The patient was doing well 16 months postoperatively with no further deterioration in neurological function and excellent fusion.

CONCLUSIONS: This procedure is technically easy and does not have the known risks of the surgical treatment of high-grade spondylolisthesis. The technique is a safe and effective single-stage procedure, and employs posterior instrumentation fundamentals as used by spinal surgeons. It is simpler to perform in high-grade slips than the other methods of lumbosacral stabilization.