I’m looking for solutions for my L5 unstable isthmic spondylolisthesis (Grade I to Grade II).
Is it true that it’s better to fuse from L4 to the pelvis in order to prevent the screws from breaking? That’s what one doctor recommended (for a 360 fusion).
If your disc at L4-5 is intact and the L5-S1 level is unstable, a simple ALIF with pedicle screws (360) or a TLIF at L5-S1 only would be the recommended procedure. Screws break due to lack of fusion which is quite rare today.