Abstract

A 7-year-old girl, a history of cleft palate surgery, presented with primary complaints of severe back pain with radiation to both lower limbs below the knees 2 months following, with inability to stand or walk, of unknown cause history. Her obstetric, developmental, and family history was normal. Inspection of her posture on standing revealed severe sagittal plane deformity including lumbosacral kyphosis and lumbar hyperlordosis with flexion at hips and knees (crouched position). with back pain radiating to the legs, motor and sensory dysfunction of the lower extremities, bladder dysfunction, and saddle anesthesias. Plain radiography and computed tomography (CT scan) showed bilateral L5 pars defect, dysplastic L5- S1 facets, trapezoidal L5 vertebral body, retroverted sacrum with rounding of proximal endplate, and complete anterior descent of the L5 vertebrae to the sacrum (Figures 2(a)–2(d)). Magnetic resonance imaging (MRI) of lumbosacral region revealed severe dural compression at L5-S1 level and L5-S1 intervertebral disc degeneration (Figure 3).

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