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Background:   Early postoperative sacral fractures are extremely rare complications of single-level posterior lumbar interbody fusions (PLIFs).    Case Description:   A 71-year-old female presented with lower back pain and right S1 radiculopathy attributed to MR-documented L5/S1 isthmic spondylolisthesis. Following a L5 laminectomy and bilateral L5/S1 PLIF, she experienced sacral pain while sitting. When the MR showed a sacral insufficiency fracture with anterolisthesis at L5/S1, a secondary posterior fusion was extended to the pelvis, utilizing bilateral iliac screws. Following this reoperation, the patient did well and went on to achieve arthrodesis.    Conclusion:   Early postoperative sacral fractures that occur following single-segment L5/S1 PLIF for isthmic spondylolisthesis warrant fusion to the pelvis with bilateral iliac screws.

Early postoperative sacral fracture after short-segment posterior lumbar interbody fusion for L5/S1 isthmic spondylolisthesis: A case report