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In adults with spinal deformity, fusion across the L5-S1 junction is recommended in the presence of lumbosacral pathology, such as postlaminectomy defects, lumbar spinal stenosis, oblique take-off of L5, and severe L5-S1 degenerative disk disease[40]. To avoid complications leading to failure of the S1 pedicle screws the use of bilateral iliac screw fixation and anterior interbody support is recommended.

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The SS is a positional parameter defined as the angle between the superior endplate of S1 and a horizontal line extending from the anterior-inferior corner of the S1 endplate. The degree of the sacral slope determines the position of the lumbar spine, since the sacral plateau forms the base of the spine[20,22].

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What does MRI impression minimal grade 1 l5-s1 retrolisthesis with mild lumbar What is Retrolisthesis?.Retrolisthesis can narrow the size of the spinal canal to allow spinal nerve irritation.

There are no conflicts of interest with regard to the present study.

2006 X-ray showed grade I retrolisthesis of L4-L5.

Flexibility of the spine should be assessed clinically and radiologically. Patients’ standing coronal and/or sagittal deformity may decrease in supine or prone position due to mobile segments. Standing long-cassette anteroposterior and lateral radiographs, supine bending, lateral fulcrum and lateral flexion and extension radiographs may demonstrate the flexibility of the deformity. Consideration of the spinopelvic parameters is critical in the surgical planning. Bridwell[38] classified spinal deformities into three categories based on curve flexibility: totally flexible, partially through mobile segments, and fixed deformity with no correction in the recumbent position.

Prior to beginning any injection therapies, L5 and S1.

Surgery is the mainstay of treatment for patients with sagittal deformity. Indications include failure of nonsurgical treatment, curve progression, back pain, radicular symptoms and significant cosmetic deformity. The goals of surgery are to achieve a solid fusion with a balanced spine in both sagittal and coronal planes, relieve pain, and prevent progression. Several studies have shown that adequate restoration of sagittal plane alignment is necessary to significantly improve clinical outcome and avoid subsequent pseudarthrosis[33-35].

Grade.2014 ICD-9-CM Diagnosis Code 756.12 Spondylolisthesis.

Fixed deformities can be managed by anterior-only, anterior and posterior combined and posterior-only approaches. With recent advances in instrumentation and techniques posterior-only approaches became very popular in recent years. Numerous studies supporting the safety and efficacy of a posterior-only approach for the treatment of all spinal deformities have been published. A recent radiographic analysis comparing posterior-only and combined anterior-posterior approaches has shown equally effective correction with the posterior-only approach[39].

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Symptomatic deformity is often unresponsive to nonsurgical treatment. Patients with back pain and sagittal imbalance may show little or only temporary improvement with physical therapy programs, selective nerve root blocks, facet joint injections, epidural steroid injections or bracing[31,32].