A modified Gaines procedure for spondyloptosis

Abstract

We present an illustrative case using a modification of the Gaines procedure for the surgical management of patients with spondyloptosis. It involves excision of the inferior half of the body of L5 anteriorly combined with posterior reduction and fusion.

Irreducible L5/S1 Spondyloptosis in Over 20 Years After Neglected Trauma Treated with Modified Grob’s Technique – Case Report

“…Notably, the mean age of the study participants was 54 years (ranging from 35 to 77 years), and the mean intraoperative blood loss was relatively low, with an average of 360 mL (ranging from 100 to 800 mL) 21 In contrast, alternative techniques described in the literature primarily targeted much younger patient populations (approximately 22 years of age) 13 , 14 , 22 , 25 and were associated with higher blood loss (approximately 2 liters). 23 , 26 , 27 Authors combined In our case, we combined Grob’s method with dural sac decompression and transpedicular stabilization at the L3-L5S1 levels. Although this approach entails a higher risk of pseudarthrosis compared to stabilization with reduction, the procedure exhibited fewer intra- and postoperative complications and appeared to be a safer and more suitable choice for our patient.…”

Acute Traumatic Spondyloptosis: A Case Report

“…Other surgical options, including the Gaines procedure (a surgical procedure for spondyloptosis which requires a separate anterior and posterior approach to the lumbosacral junction) and its variations, have shown success in previous cases with neurologic impairment upon presentation. While effective, they carry a high risk for severe neurologic impairment [ 10 , 11 ]. Posterior instrumentation using a rod and screw system has been suggested to be a useful method for reduction, stabilization, and decompression of L5-S1 spondylolisthesis [ 12 ].…”