====== Sacral spondyloptosis ======
Grade V [[spondylolisthesis]], or [[spondyloptosis]], is a complication of [[high-energy trauma]] that is most commonly reported at the [[lumbosacral junction]]. Sacral intersegmental spondyloptosis is extremely rare. Tracz et al. presented a case of spondyloptosis of [[S1]] on [[S2]] with a comminuted fracture of S2 and complex fractures of the [[L4]] and [[L5]] [[transverse process]]es, resulting in severe stenosis of the lumbosacral [[nerve root]]s.

The patient was a 70-year-old woman with a history of a fall 3 weeks prior and progressive L5 and S1 radiculopathy. Instrumentation and fusion were undertaken, extending from L3 to the pelvis because degenerative stenosis at L3-4 and L4-5 was also found. Reduction was achieved, leading to diminished pain and partial resolution of weakness.

Traumatic sacral spondyloptosis adds a degree of difficulty to reduction, fixation, and fusion. The technique presented herein achieved sagittal realignment via a distraction maneuver of S1-2 in which rods were attached to bilateral dual [[S2 alar-iliac screw]]s with reduction screws placed at S1, ultimately pulling L5 and S1 up to the rod for fixation
((Tracz JA, Judy BF, Sacino AN, Bydon A, Witham TF. Management of traumatic sacral spondyloptosis: illustrative case. J Neurosurg Case Lessons. 2022 Jul 18;4(3):CASE22221. doi: 10.3171/CASE22221. PMID: 36046707; PMCID: PMC9301347.)).