CASE 3
As he was being tackled in a high school football game, the 17-year-old running back was speared in the back. As he walked off the field with difficulty, he complained of lower back pain and tightness of his hamstrings. He was transported by ambulance to the emergency department. The following observations were made during the physical examination: hyperlordosis of the lumbar region, unable to flex hips with knees extended, and a prominently palpable L5 spinous process. Obliquely-oriented x-rays of the lumbosacral region showed bilateral fractures of the pars interarticularis of vertebra L5 and a 35% anterior displacement (slippage) of its body. The diagnosis was spondylolisthesis with a high-grade slip, and spinal fusion surgery was performed to stabilize the segment of listhesis and to decompress the nerve roots.
