Traumatic L5/S1 bilateral locked facets with bilateral pars fractures – A case report

BACKGROUND: Although rare, traumatic lumbosacral (L/S) Grade I spondylolisthesis (i.e., Lumbar locked facet syndrome) is characterized by unilateral or bilateral facet dislocations. CASE DESCRIPTION: A 25-year-old male presented following a high velocity road traffic accident with back pain and tenderness at the L/S junction. His radiologic images showed bilateral locked facets at the L5/S1 level with Grade 1 spondylolisthesis, bilateral pars fractures, acute traumatic L5/S1 disc herniation, and disruption of the anterior and posterior longitudinal ligaments. After undergoing a L4-S1 laminectomy with pedicle screw fixation, he became asymptomatic and remained neurologically stable. CONCLUSION: L5/S1 facet dislocation whether unilateral or bilateral needs to be diagnosed early and treated with realignment and instrumented stabilization.