- 期刊
Treatment of L5 Sever Spondylolisthesis by Total L5 Resection, Sacroplasty and Circumferential Fusion-Two Cases Report
並列摘要
A modification of Gaines procedure including three steps to treat severe spondylolisthesis in one stage is utilized in two case. The first step consists of L5 corpectomy and partial sacral dome excision. The second step consists of the removal of the remaining portion of L5 including spinal process, articular processes, pedicles of L5, and reduction of L4 onto the sacrum with RF (Reduction Fixation) instrumentation and bilateral posteriolateral fusion between L4 and S1. The third step consists of checking the opposing of L4 onto S1, improving contact area of L4 on S1 and securing the anterior bone grafts (sacroplasty). Postoperatively, one patient had early transient neuropraxia, but got complete recovery 3 months after operation. Both patients maintained the reduction and got bony union more than 18 months after operation and got muth sympotomatic improvement. This modified Gaines procedure with sacroplasty and circumferential fusion is a one-stage endeavor designed to correct the severe sagittal imbalance, improve the contact area of L4 onto S1, provide the rigid fixation and maintain steady stability after reduction for patients with severe spondylolisthesis. The goals are to restore the cosmetic appearance, enable early mobilization and increase the union rate.
延伸閱讀
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