Triple spondylolyse bilatérale lombaire étagée

We report the case of a 30-year old patient, with no particular pathological history but with a 6-months history of lower back pain without radiculalgia in the lower limbs. Neurological examination showed lumbar spinal syndrome without neurological deficit. Lumbar spine CT scan on the right (A) and left (B) paramedian sagittal slices showed bilateral three-level L2, L3, L4 spondylolysis associated with grade I spondylolisthesis at L3-L4, according to Meyerding classification. Clinical evolution was marked by disappearance of the symptoms after analgesic, non-steroidal antiinflammatory therapy as well as by lumbar belt stabilization at the end of two weeks of treatment. The rate of lumbar spondylolyses in adults is approximately 6%, affecting in more than 90% of cases the L5 vertebra. Multilevel lumbar spondylolysis is unusual, accounting for 1.2% to 5.6% of lumbar spondylolyses and affecting, in more than 60% of the case, 2 levels, including L4-L5. Conservative treatment associated with regular follow-up is indicated in the case of absence of neurologic symptoms with or without spondylolisthesis at less than 25%.