Int J Spine Surg 2025, 19 (4) 362-369
This case report describes the first use of a combined 360° motion-preserving surgery—utilizing Prodisc L Artificial Disc and TOPS facet replacement—for grade III lumbar spondylolisthesis, showing rapid pain relief, improved function, and high patient satisfaction, suggesting a potential alternative to spinal fusion for select patients.
• First reported case of grade III lumbar spondylolisthesis treated with a novel 360° motion-preserving solution combining Prodisc L Artificial Disc Replacement and the Premia TOPS System.
• Traditional treatment is spinal fusion, but it reduces motion and can cause adjacent segment disease, especially problematic for younger, active patients.
• The patient, a 36-year-old man with progressive L5-S1 grade III spondylolisthesis and severe disc collapse, had failed conservative therapy and declined fusion.
• Surgery was performed in two stages: anterior artificial disc replacement, followed by posterior facet replacement with the TOPS device.
• Significant improvements were seen in pain, function, and satisfaction, with the patient pain-free and highly satisfied by 3 and 9 months post-op.
• This case suggests the 360° arthroplasty approach may offer a motion-preserving alternative to fusion for high-grade spondylolisthesis.
• Further research and long-term data are needed to confirm safety, durability, and broader effectiveness.
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