Introduction and importance: Double level isthmic spondylolisthesis at L3-L4/L4-L5 is exceedingly rare with only a few documented cases in the literature, but to our knowledge no detailed case reports have been written.
Case presentation: 49 year old male with L3-4, L4-5 isthmic spondylolisthesis with neurologic symptoms and failed conservative management treated with L3-4, L4-5 Gill laminectomy, transforaminal interbody fusion with bone grafting and L3-5 posterior instrumented fusion.
Clinical discussion: While rare, this condition can be successfully treated with posterior decompression and instrumented interbody fusion similar to single level spondylolisthesis. Surgeons should feel confident that they can achieve a good outcome for patients and feel comfortable offering this procedure.
Conclusion: This case report may offer guidance for surgeons in the future as it explores the successful treatment of double level isthmic spondylolisthesis at L3-L4/L4-5 from initial presentation to final post-operative follow-up where the patient had complete resolution of symptoms.
Keywords: Double level isthmic spondylolisthesis; Gill laminectomy; Posterior instrumented fusion; Transforaminal interbody fusion.
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