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Published in: European Spine Journal 2/2016

01-02-2016 | Original Article

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

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

Published in: European Spine Journal | Issue 2/2016

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Abstract

Study design

A case series of seven consecutive patients with L5–S1 spondyloptosis (SPP) and Meyerding IV spondylolisthesis (HGSPL) treated consecutively by a new surgical technique with partial reduction and fixation after spinal shortening.

Objective

To report clinical and radiological outcomes of a spinal shortening procedure by a single posterior approach in seven patients with HGSPL and SPP.

Background data

The surgical treatment of L5–S1 SPP and HGSPL remains challenging, and numbers of surgical treatment options have been described with several principles. We reported a new surgical technique achieving partial reduction and fixation of L5–S1 SPP and HGSPL and highlighted its clinical and radiological outcomes.

Methods

Seven patients with Meyerding Grade IV (2), and Grade V (5) were operated consecutively between 2004 and 2011 for HGSPL and SPP. Surgery time, blood loss and complications were collected for all patients. The slip angle or Dubousset lumbo-sacral Angle (Dub-LSA), L5 slip percentage (%slip), pelvic tilt (PT), lumbar lordosis (LL), thoracic kyphosis (TK) and C7-tilt were measured pre and postoperatively. All patients underwent posterior one-stage decompression with sacral dome osteotomy, L5 vertebrectomy with L5-S1 discectomy, and partial reduction and instrumented fusion in a single posterior approach.

Results

The mean age and follow-up were, respectively, 20 years and 65 months. The mean preoperative  %slip was 115 %, which improved to 63 % postoperatively. The mean preoperative Dub-LSA, PT, LL, TK, and C7-tilt were 37°, 31°, −74°, 30°, and 6°, respectively, which improved to 94°, 25°, −44°, 42° and −0.14° postoperatively. No implant failure or pseudarthrosis were reported at last follow-up.

Conclusion

This novel and efficient one-stage shortening technique offers the possibility to manage lumbosacral kyphosis and spinal local malalignment in L5–S1 SPP.
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Metadata
Title
One-stage posterior spinal shortening by L5 partial spondylectomy for spondyloptosis or L5–S1 high-grade spondylolisthesis management
Authors
Ibrahim Obeid
Féthi Laouissat
Anouar Bourghli
Louis Boissière
Jean-Marc Vital
Publication date
01-02-2016
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 2/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-015-4174-9

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