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Neurological Rehabilitation

A Rare Presentation of Chronic Spondyloptosis

Friday, October 24, 2025
12:00 PM - 1:30 PM MT
Location: Kiosk 5

    Poster Presenter(s)

  • Annie Tuman, MD

    Resident
    Emory University School of Medicine PM&R Program
    Atlanta, Georgia

    • Co-Author(s)

  • Darby Oakes, DO, MPH

    Resident Physician
    Emory University School of Medicine PM&R Program
    Atlanta, Georgia

  • JG

    Julia Grote, Other

    Medical Student
    Nova Southeastern University Dr Kiran C Patel College of Osteopathic Medicine
    Fort Lauderdale, Florida

  • HM

    Hassan Monfared, MD

    Assistant professor and Physician faculty at Emory University SOM; atlanta, GA
    Emory University School of Medicine PM&R Program
    Marietta, Georgia

Disclosure(s):
Annie Tuman, MD: No financial relationships to disclose
Darby Oakes, DO, MPH: No financial relationships to disclose
Hassan Monfared, MD: No financial relationships to disclose
Case Diagnosis: Chronic spondyloptosis causing spinal cord compression in an 18 year old female.

Case Description or Program Description: The patient is an 18 year old female with past medical history of two years of non-traumatic low back pain and lumbar radiculopathy, evaluated outpatient by neurosurgery 11/2024-2/2025 for severe neurogenic claudication impacting quality of life as a freshman in college and prompting multiple ED visits. During this time she also developed perianal, genital numbness, urinary urgency, and one episode of urinary incontinence.

Setting: Emory Rehabilitation Hospital

Assessment/Results: Lumbar MRI demonstrated spondyloptosis at L5-S1 with severe neural foraminal narrowing and central canal narrowing. She underwent planned L4-S1 laminectomy and L3-ileum posterior fusion and completed IV Decadron burst prior to her acute rehabilitation stay. Post-operative imaging showed significantly decreased anterolisthesis with stable hardware. Admission ISNCSCI exam was suggestive of L1 AIS D incomplete paraplegia. The patient regained lower extremity strength and continence, though her lower extremity and perianal/genital sensation remained altered.

Discussion (relevance): Spondyloptosis refers to anterolisthesis of the entire L5 vertebral body below the top of S1, with the Greek origin of the word being spondylo (vertebra) and ptosis (to fall). While spondylolysis and spondylolisthesis are commonly seen in the rehab setting, spondyloptosis represents the most severe degree of slippage possible, and is quite rare. Spondyloptosis is usually the result of high-energy trauma and accompanied by severe spinal cord injury. However, this patient presented with chronic, non-traumatic symptoms and only mild damage to the spinal cord, as indicated by her AIS D impairment scale.

Conclusions: This case outlines a unique case of spondyloptosis, the rarest form of spondylolisthesis. To our knowledge, this is one of only a few documented case reports detailing a chronic, non-traumatic spondyloptosis.