Two-stage operative therapy of L5 vertebra spondyloptosis (surgery technique introduced by R. Gaines)
Bulatov, A., Kubeckiy, Y., Evsyukov, A., Rzaev, J. (2022). Two-stage operative therapy of L5 vertebra spondyloptosis (surgery technique introduced by R. Gaines). EKB Journal Management System, 17(2), 83-88. doi: 10.21608/pajn.2022.108045.1040
Aleksandr Bulatov; Yuliy Kubeckiy; Aleksey Evsyukov; Jamil Rzaev. "Two-stage operative therapy of L5 vertebra spondyloptosis (surgery technique introduced by R. Gaines)". EKB Journal Management System, 17, 2, 2022, 83-88. doi: 10.21608/pajn.2022.108045.1040
Bulatov, A., Kubeckiy, Y., Evsyukov, A., Rzaev, J. (2022). 'Two-stage operative therapy of L5 vertebra spondyloptosis (surgery technique introduced by R. Gaines)', EKB Journal Management System, 17(2), pp. 83-88. doi: 10.21608/pajn.2022.108045.1040
Bulatov, A., Kubeckiy, Y., Evsyukov, A., Rzaev, J. Two-stage operative therapy of L5 vertebra spondyloptosis (surgery technique introduced by R. Gaines). EKB Journal Management System, 2022; 17(2): 83-88. doi: 10.21608/pajn.2022.108045.1040

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, Page 83-88  XML PDF (1.39 MB)
Document Type: Case Reports
DOI: 10.21608/pajn.2022.108045.1040
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Authors
Aleksandr Bulatov email orcid 1; Yuliy Kubeckiyorcid 1; Aleksey Evsyukovorcid 2; Jamil Rzaevorcid 1
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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