ArticleOrthopaedic surgery2025
Treatment of L5-S1 Spondyloptosis via Posterior-Only L5 Partial Spondylectomy and Reduction of L4 Onto S1: Surgical Technique and Case Series.
Article in Orthopaedic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveSpondyloptosis (Grade-V spondylolisthesis) is the most severe form of spondylolisthesis and presents significant surgical challenges due to its rarity and complexity. This study aimed to outline the key aspects of posterior-only L5 partial spondylectomy and reduction of L4 onto S1 for spondyloptosis, as well as evaluate the clinical outcomes and prospects of this technique.
methodsThree patients diagnosed with L5/S1 spondyloptosis between July 2022 and June 2023 were assessed. All these patients underwent posterior-only L5 partial spondylectomy with L4-S1 reduction, using a modified Kebaish's technique. The surgical approach was described in detail, and patient outcomes were assessed through postoperative imaging and clinical measures.
resultsThe mean age of the patients was 28.7 years (range, 13-41). Preoperative assessments showed a mean Visual Analog Scale (VAS) score for low back or lower limb pain of 5.3 (range 5-6), an Oswestry Disability Index (ODI) of 57.3% (40%-74%), and a Japanese Orthopedic Association-29 (JOA-29) score of 15.7 (13-19). The mean operative time was 469 min (455-483), with a mean estimated blood loss of 1400 mL (1200-2000). The average follow-up duration was 14 months (12-18). At the final follow-up, all the patients achieved solid fusion, confirmed via computed tomography. Postoperative VAS, ODI, and JOA-29 scores improved to 2 (0-3), 17.3% (6%-26%), and 23 (22-25), respectively. All the patients reported high satisfaction with the treatment.
conclusionsPosterior-only L5 partial spondylectomy with L4-S1 reduction is a feasible and effective treatment for lumbar spondyloptosis. Although technically demanding and associated with a high risk of nerve palsy, this approach can yield favorable clinical outcomes when applied appropriately in these challenging cases.
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