{"id":"19730077-44ba-4028-b12b-37fe128abe08","slug":"navigation-assisted-reduction-and-fusion-for-3-cases-of-high-grade-pediatric-dysplastic-spondylolisthesis-a-technical-note","title":"Navigation-assisted reduction and fusion for 3 cases of high-grade pediatric dysplastic spondylolisthesis – A technical note","authors":["Shailesh Hadgaonkar","Sameer Nagpal","Abhinav Ramesh Bhute","Parag Sancheti"],"abstract":"Background: High-grade dysplastic spondylolisthesis in the pediatric population presents significant anatomical and biomechanical challenges due to sacral doming, dysplastic pedicles, and altered spinopelvic parameters. There are high rates of non-union and instrumentation failure, especially without anterior column support. Intraoperative navigation improves accuracy in placing instrumentation and deformity correction. Methods: Three pediatric patients with high-grade dysplastic L5–S1 spondylolisthesis underwent reduction and circumferential spinopelvic fixation utilizing intraoperative 3D navigation. Key technical steps included insertion of convergent bi-cortical pedicle screws, sacral dome osteotomy, inter-body cage placement at L5–S1, and controlled reduction maneuvers. One patient’s fusion failed and warranted transcorporeal transdiscal screw fixation. Results: All 3 patients showed notable correction in deformity (i.e., a mean lumbosacral kyphosis reduction of 20° and slip angle correction of 13.3°). Sagittal balance improved from 6.3 cm to 3.3 cm anterior to the sacral promontory. Two of three patients achieved solid mono-block fusion, while one exhibited loss of reduction following a fall, requiring re-instrumentation and a transcorporeal transdiscal screw fixation. Conclusion: Intraoperative navigation facilitates accurate screw placement, safe reduction, and successful fusion for 3 pediatric patients with high-grade pediatric dysplastic spondylolisthesis.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/19730077-44ba-4028-b12b-37fe128abe08/featured/hero-1781558376945.png","publishDate":"2025-09-05T00:00:00.000Z","doi":"10.25259/SNI_707_2025","categories":["Spine","Technical Note"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2025/09/13934/SNI-16-381.pdf"}