The patient was operated by me 1997 for spondylolisthesis of L4-5 using Luque rectangles with sublaminar wires, which were popular at that time.

The patient then came to me 03-October-2007 and gout, Behjcet disease, effusion both knees  with arterial hypertension were diagnosed and treated accordingly. She came with LSSX-ray showing good alignment of the construct.

The patient then came 05-October-2010 with agonizing LBP and right sciatica. She was irritable and could not find a position to relief her pain. This happened 2 days ago after lifting her father.

LSS X-ray done 04-Octobber-2010 showing the Luque rectangle fractured in the middle and the sublaminar wires are broken at several places.

On examination: The patient cannot be put in the examination bed to evaluate her, but SLRS was 05 degrees in the right with pain with no motor or sensory deficit. The patient now in colchecine  and cortisone 5 mg. Amlodepine 5 mg and Hypoten daily 50 mg daily.

The old wound was refreshed and the construct was identified and all the sublaminar wires were removed. The rectangle was broken in midway both sides. Check X-ray confirmed the presence of two metallic pieces under the lamina of L3 and L4, which were also removed. Control X-ray confirmed the complete removal of all parts of the Luque construct.

Routine closure of the wound and smooth postoperative recovery disappearance of right sciatica.

The patient suffered heavy stress that was the cause of device fracture with interruption of the sublaminar wires in the upper side.

The loose metallic fragments were the cause of the agonizing pain. Removal of them is a must.

The disc space of L4-5 became shallow and calcified over the last 13 years, that no more fixation is needed.