Lumbosacral Nerve Root Anomaly Associated With Spondylolisthesis in an Adolescent: A Case Report and Review of the Literature

In Brief Study Design. Case report. Objective. We describe the case of a lumbosacral nerve root anomaly in a 16-year-old male with spondylolisthesis and neurologic findings exceeding that that was expected of the underlying deformity. A complete review of clinical, radiologic, and operative records was performed. Summary of Background Data. Spondylolisthesis is a relatively common cause of lower back pain in adolescents. Neurologic findings may occur, most commonly associated with higher grade spondylolisthesis and spondyloptosis. Lumbosacral nerve root anomalies have been reported and are typically associated with neurologic symptoms in excess of the underlying deformity. Methods. The 16-year-old male presented with lower back pain, difficulty walking, and sensory and motor symptoms in the L5 and S1 nerve root distributions. Radiographs revealed a Meyerding grade III spondylolisthesis, with a slip angle of 14° and a lumbosacral angle of 76°. Neither computerized tomography nor magnetic resonance imaging revealed the presence of lumbosacral nerve root anomalies. Results. Intraoperatively, an L5–S1 anastomotic nerve root on the left side was identified. Conclusions. This case emphasizes the need to consider the presence of lumbosacral nerve root anomalies in cases in which neurologic findings exceed what would be anticipated. Preoperative identification of these anomalies allows for their existence to be considered in the surgical plan. A lumbosacral nerve root anomaly in a 16-year-old male with spondylolisthesis and neurologic findings exceeding that that was expected is presented. Intraoperatively, an L5-S1 anastomotic nerve root was identified. Preoperative identification of these anomalies allows for their existence to be considered in the surgical plan.