Anterior lumbar interbody fusion augmented with anterior screw fixation for the treatment of L5/S1 spondylolisthesis: a case report

BACKGROUND: Various procedures, including anterior and posterior approaches, have been shown to be effective in the treatment of lumbar spondylolisthesis. Anterior approaches, such as stand-alone anterior lumbar interbody fusion (ALIF) and ALIF augmented with posterior screw fixation (ALIF + PSF), are considered options for spondylolisthesis at the L5/S1 segment. However, stand-alone ALIF is associated with concerns of stability, and ALIF + PSF is associated with postoperative low back pain because of its impact on posterior elements. The concept of anterior screw fixation (ASF) is an innovative approach for screw insertion within the ALIF procedure. Without the need to acquire extra incisions, ALIF + ASF avoids posterior element impact and provides reliable stability. Thus, we innovatively proposed and performed ALIF + ASF for the treatment of low-grade L5/S1 spondylolisthesis. CASE PRESENTATION: Two Han Chinese-descent male patients (one 60 years old and one 40 years old) underwent ALIF + ASF surgery due to L5/S1 spondylolisthesis. CONCLUSIONS: Anterior lumbar interbody fusion augmented with anterior screw fixation for the treatment of L5/S1 spondylolisthesis is feasible and effective.