Two-stage operative therapy of L5 vertebra spondyloptosis (surgery technique introduced by R. Gaines) | ||
| Pan Arab Journal of Neurosurgery | ||
| Article 13, Volume 17, Issue 2, December 2022, Pages 83-88 PDF (1.39 M) | ||
| Document Type: Case Reports | ||
| DOI: 10.21608/pajn.2022.108045.1040 | ||
| Authors | ||
| Aleksandr Bulatov* 1; Yuliy Kubeckiy1; Aleksey Evsyukov2; Jamil Rzaev1 | ||
| 1Federal Neurosurgical Center, Federal State Budgetary Institution under the RF Ministry of Healthcare, city of Novosibirsk, Russia | ||
| 2The Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics, Federal State Budgetary Institution under the RF Ministry of Healthcare, city of Kurgan | ||
| Abstract | ||
| Abstract Grade V spondylolisthesis or spondyloptosis is a clinical state quite rare for the population of less than 1% (1, 2). The main aspects of operative improvement are rather few in number. One-stage spondyloptosis treatment involves in situ fixation, partial reduction and stabilization (3,4). Another option, when the surgical aid includes a multi-stage approach for this pathology, for example, by L5 vertebrotomy with L4 - S1 interbody fusion development, was described by R. Gaines (1). But this procedure is accompanied by a high complications risk described by the author himself (2,5). Herein a case of surgical treatment of 27 years old young man, who filed a complaint stating severe lumbar pain and pain in both legs is observed. In particular, L5 vertebra spondyloptosis was detected. The patient has undergone a two-stage R. Gaines surgery, including L5 vertebrotomy, L4 vertebra repositioning over S1, L4-S1 interbody fusion with mesh cage and L3-L4-S1-S2-alar transpedicular fixation. 12 months later, after bone block shaping at L4-S1 level, a part of screw attachment system was removed. L5 vertebra dislocation (100% dislocation) was measured, and the parameters of sagittal modifiers: (PI, PT, LL, L4-S1, SS, TK, SVA) were assessed. Clinical outcomes were monitored using VAS, ODI and MacNab scales. After 18 months, the patient was able to resume his working activity associated with hard physical labor. | ||
| Keywords | ||
| surgery technique introduced by R. Gaines; spondyloptosis; high grade spondylolisthesis; L5 vertebrotomy; vertebral column shortening | ||
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