TREATMENT OF A CASE WITH L5–S1 SPONDYLOPTOSIS BY THE GAINES PROCEDURE

Abstract

Gaines procedure for the treatment of spondyloptosis was performed on an 18-year-old girl, a two-staged operation on the same day. In the first stage, the vertebral body of L5 along with the L4–5 and L5–S1 discs were resected by an anterior approach. In the second stage, performed through a posterior approach, the loose posterior elements, articular processes and pedicles of L5 were excised; the body of L4 was reduced onto S1 and stabilized by transpedicular instrumentation. Despite the relatively high complication rates that such procedures incur, the procedure corrected the sagittal imbalance in our case without any complications during the long four years follow-up period of the patient. A brief summary of the clinical experience, the surgical technique and a review of relevant literature are presented.