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CASE REPORT
Year : 2019  |  Volume : 2  |  Issue : 2  |  Page : 184-189

Modified three-stage Gaines procedure for symptomatic adult spondyloptosis


Department of Spine Surgery, MIOT Hospitals, Chennai, Tamil Nadu, India

Correspondence Address:
Dr. Charanjit Singh Dhillon
Flat 2083, Appaswamy Platina Apartments, 107 Mount-Poonamallee Road, Porur, Near Saravana Stores, Chennai - 600 116, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/isj.isj_51_18

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Spondyloptosis or complete anterior dislocation of the L5 vertebra over S1 is a rare clinical condition. In general, the surgical management of spondyloptosis includes either posterior long-segment in situ fusion (with total disregard for altered biomechanics) or restoration of lumbosacral kyphosis by reduction of spondyloptosis using multistaged procedures. Reduction is possible in spondyloptosis only after sacral dome osteotomy or L5 corpectomy with interbody fusion of L4 over S1 as described by Robert Gaines. We present the case of a 29 year old manual laborer who presented with complaints of severe low back pain and bilateral sciatica. He was diagnosed to have spondyloptosis of L5 over S1 with modified Newman's score of 10 + 10. The patient underwent three-staged modified Gaines procedure in the form of L5 corpectomy, reduction of L4 over S1 and interbody fusion between L4 and S1. The reduction was maintained at the end of 18 months and he was able to resume his job as a manual laborer.


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