One-stage posterior spinal shortening by L5 partial spondylectomy for spondyloptosis or L5–S1 high-grade spondylolisthesis management

Obeid, Ibrahim; Laouissat, Féthi; Bourghli, Anouar; Boissière, Louis; Vital, Jean-Marc

doi:10.1007/s00586-015-4174-9

Cited by 11 publications

(4 citation statements)

References 21 publications

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“…23,59,[65][66][67] Despite this, a similar technique involving a partial L5 vertebrectomy with resection of the S1 dome and posterior L4-S1 and iliac arthrodesis has been associated with a shorter surgical time, less bleeding, and lower risk of nerve injury. 68,69 Regardless of the interbody fusion used, it is common to perform decompression techniques such as laminectomies, microdiskectomies, and/or foraminotomies to relieve radicular pain. 27,28 Concerning the extent of the arthrodesis, fixation to L4 is preferred when reduction is performed.…”

Section: Resultsmentioning

confidence: 99%

Minimally Invasive Surgery for Managing Grade IV and V Spondylolisthesis

Ramirez Velandia,

Gomez Cristancho,

Urrego Nieto

et al. 2023

Asian J Neurosurg

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Surgical treatment of high-grade spondylolisthesis is controversial and aims at restoring the spinopelvic sagittal balance through complete or partial reduction of the listhesis. Nerve decompression and interbody fusion are necessary for patients presenting with neurological deficit, severe pain, lower limb asymmetry, or deformities. We present the case and the results of a patient with high-grade spondylolisthesis, in whom minimally invasive management was performed. A narrative review in this topic is also provided.We performed a literature review of high-grade spondylolisthesis to compare our technique to current surgical alternatives. We included articles from PubMed, Embase, Scopus, Ovid, and Science Direct published between 1963 and 2022 that were written in English, German, and Spanish. The terms used were the following: “high grade spondylolisthesis,” “spondyloptosis,” “surgical management,” “interbody fusion,” and “arthrodesis.” In all, 485 articles were displayed, from which we filtered 112 by title and abstract. At the end, 75 references were selected for the review.Different interbody fusion techniques can be used to correct the lumbosacral kyphosis and restore the spinopelvic parameters. A complete reduction of the listhesis is not always required. The surgical procedure carried out in our patient corresponds to the first known case of minimally invasive circumferential arthrodesis with iliac screws and sacral fixation in a high-grade dysplastic spondylolisthesis. This approach guarantees the correction of the lumbosacral kyphosis and a complete reduction of the listhesis. Further studies are required to determine whether the results of this case can be extrapolated to other patients with high-grade spondylolisthesis.

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Section: Resultsmentioning

confidence: 99%

Minimally Invasive Surgery for Managing Grade IV and V Spondylolisthesis

Ramirez Velandia,

Gomez Cristancho,

Urrego Nieto

et al. 2023

Asian J Neurosurg

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“…Furthermore, partial vertebrectomy was first described by Reyes-Sanchez et al (9) in 2002 for the treatment of burst fractures and was successfully applied in other spinal diseases (20,21). Later, Obeid et al (22) described a novel spinal shortening technique using a one-stage posterior L5 partial spondylectomy for the management of L5-S1. This seven-case series study showed its safety and efficiency in spondyloptosis reduction.…”

Section: Discussionmentioning

confidence: 99%

“…First, the reduction ends are technically demanded to be curetted until the cancellous bone is well exposed, thus ensuring direct and tight bone-on-bone contact between two ends under axial compression to enhance osteogenesis (25). However, this technical procedure of cancellous bone-on-bone contact instead of vertebral endplates brings an additional risk of subsidence of the vertebral bodies that are overlapped on each other, as indicated by Obeid et al (22) in their management of L5 spondyloptosis using a partial vertebrectomy. Hereby, adequate circumferential fusion with bone grafting of autogenic bone and allogenic bone grafts is strongly suggested as the supplemental procedure to improve spinal fusion (26)(27)(28).…”

Section: Discussionmentioning

confidence: 99%

Partial vertebrectomy with spine shortening for old spondyloptosis at the thoracolumbar spine: a case series study and literature review

Liu

Kang

et al. 2023

Front. Surg.

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ObjectiveWe aimed to report the surgical outcomes of serial cases and retrospectively analyze the value of partial vertebrectomy and spinal shortening in the reduction of old spondyloptosis at the thoracolumbar spine.MethodsFrom 2015 to 2021, eight cases of patients who received a spinal intervention of partial vertebrectomy and spinal shortening for thoracolumbar spondyloptosis over 3 weeks post-trauma were retrospectively summarized. Medical records and surgical outcomes were extracted for clinical safety and efficacy evaluation.ResultsAcceptable reduction and immediate stabilization were achieved for all eight cases without causing iatrogenic damage to the viscera. The mean operation time was 3.7 h (range, 3.2–4.2 h) with a mean blood loss average of 1,081 ml (range, 900–1,300 ml). Postoperative stay in the spine department was an average of 11.4 days (range, 8–17 days), followed by an early rehab program. The mean visual analog scale (VAS) for low back pain decreased from 8.0 preoperatively to 1.4 at the last follow-up. The average follow-up period was 19.9 months. As for neurological function recovery, six patients with preoperative ASIA-A status remained unchanged throughout the follow-up period and improvement of one ASIA grade was noted in two patients. At the latest follow-up, sound interbody fusion as well as good alignment of the spinal column were confirmed radiologically in seven patients, while one patient encountered slight re-dislocation 3 months after surgery, but eventually achieved spinal fusion.ConclusionPartial vertebrectomy and spine shortening via a posterior approach showed good efficacy and safety in the management of old spondyloptosis of the thoracolumbar spine, allowing for a one-step good reduction and spinal fusion for early rehabilitation.

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“…A recent case series of 7 consecutive patients with L5-S1 spondyloptosis of Meyerding IV spondylolisthesis treated by a 1-stage L5 spondylectomy demonstrated at mean 65 months follow-up that slip percentage improved from 115% to 63% postoperatively and that the PT, LL, and thoracic kyphosis also improved. 79…”

Section: Vertebrectomymentioning

confidence: 99%

High-Grade Spondylolisthesis in Adults: Current Concepts in Evaluation and Management

et al. 2020

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Background: Information regarding the treatment of high-grade spondylolisthesis (HGS) in adults has been previously described; however, previous descriptions of the evaluation and surgical management of HGS do not represent more recent and now established approaches. The purpose of the current review is to discuss current concepts in the evaluation and management of patients with HGS. Methods: Literature review. Results: HGS is diagnosed in up to 11.3% of adults with spondylolisthesis and typically presents as nonspecific lower back pain. Regarding evaluation, a thorough history and physical examination should be performed, which may help predict the presence of HGS. Diagnostic imaging, and specifically the use of spino-pelvic parameters, are now commonly implicated in guiding treatment course and prognosis. When surgical intervention is indicated, surgical approaches include in situ fusion variations, reduction and partial reduction with fusion, and vertebrectomy. Although the majority of studies suggest improvements with these approaches, the literature is limited by a low level of evidence with regards to the superiority of one technique when compared with others. Conclusions: HGS is a unique cause of low back pain in adults that carries considerable morbidity, but rarely presents with neurologic symptoms. Although the definitions, classifications, and methods of diagnosis of this spinal deformity have been established and accepted, the ideal surgical management of this deformity remains highly debated. Fusion in situ techniques are often technically easier to perform and provide lower risk of neurologic complications, whereas reduction and fusion techniques offer greater restoration of global spino-pelvic balance. Preoperative spinopelvic parameters may have utility in assisting in procedural selection; however, future, higher-quality and longer-term studies are warranted to determine the optimal surgical intervention among the widely available techniques currently used, and to better define the indications for these interventions.

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One-stage posterior spinal shortening by L5 partial spondylectomy for spondyloptosis or L5–S1 high-grade spondylolisthesis management

Abstract: This novel and efficient one-stage shortening technique offers the possibility to manage lumbosacral kyphosis and spinal local malalignment in L5-S1 SPP.

Cited by 11 publications

References 21 publications

Minimally Invasive Surgery for Managing Grade IV and V Spondylolisthesis

Minimally Invasive Surgery for Managing Grade IV and V Spondylolisthesis

Partial vertebrectomy with spine shortening for old spondyloptosis at the thoracolumbar spine: a case series study and literature review

High-Grade Spondylolisthesis in Adults: Current Concepts in Evaluation and Management

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