Grade 1 Isthmic Spondylolisthesis | Jonathan R. Stieber, MD

History

A respected Physical Medicine and Rehabilitation specialist approached our practice after debilitating low back and leg pain, accompanied by numbness, forced him to take leave from his work. Despite comprehensive non-operative treatments—physical therapy, injections, and medications—his symptoms progressively worsened, compromising both his professional and personal life.

Examination

Advanced imaging revealed a Grade I isthmic spondylolisthesis at L5–S1. This slippage created significant axial back pain and compressed the exiting L5 nerve roots, producing severe radiculopathy and sciatica that left our patient unable to stand, walk, or engage in daily activities without intense pain.

Treatment Strategy

Given the failure of conservative measures and the severity of nerve compression, we devised a two-part surgical plan:

Anterior Lumbar Interbody Fusion (ALIF) at L5–S1 through a mini-open approach to restore disc height, stabilize the vertebral segment, and relieve axial load.
Minimally Invasive, Robot-Assisted Posterior Decompression and Fusion to precisely decompress the L5 nerve roots and reinforce stability with pedicle screw fixation.

Surgical Procedure

Under general anesthesia, the team first performed the ALIF through a targeted 3-inch incision in the lower abdomen, placing an interbody spacer and bone graft to reestablish disc space height. Immediately afterward, with the patient repositioned prone, we employed robotic guidance to carry out a posterior decompression via tubular retractors—removing ligamentous and bony elements compressing the nerve roots—followed by percutaneous pedicle screw placement and rod fixation.

“I skied 6 days straight and felt great. Thank You!!!”

Postoperatively, our patient experienced immediate relief of his radicular symptoms. Mobilized on postoperative day one with physical therapy, he resumed light duties within weeks and returned fully to clinical practice shortly thereafter. By nine months, he had reclaimed his active lifestyle—skiing six days straight with his family, pain-free.

Ready to reclaim your life from spine pain? Schedule a consultation today and discover how our tailored surgical solutions can restore your mobility and well-being.

Schedule a Consultation And Get The Pain-Free Lifestyle You Deserve

NYC spine surgery specialist, Dr. Jonathan Stieber, provides his patients with the most effective treatment options available, all of which are tailored to meet your individual needs. With Dr. Stieber guiding your care, it is possible to say goodbye to pain and enjoy an active lifestyle once again.