alexa A Modified Gaines Approach for Lumbosacral Traumatic Spondyloptosis: A Historical Review and Case Illustration
ISSN: 2165-7939

Journal of Spine
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Case Report

A Modified Gaines Approach for Lumbosacral Traumatic Spondyloptosis: A Historical Review and Case Illustration

Eisha Christian1*, Christina Huang1, Christina Yen4, Frank A Acosta1,3, Thomas C Chen1,3, John C Liu1,3,
Mark Spoonamore2,3, Jeffrey C Wang2,3 and Patrick C Hsieh1,3
1Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
2Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
3USC Spine Center, Keck Medical Center of USC, Los Angeles, California, USA
4Keck School of Medicine, Los Angeles, California, USA
Corresponding Author : Eisha Christian
Department of Neurological Surgery
Keck School of Medicine, University of Southern California
1200 North State St. Suite 3300 Los Angeles, CA 90033, USA
Tel: 323.226.7421
Fax: 323.226.7833
E-mail: [email protected]
Received June 10, 2014; Accepted July 28, 2014; Published August 01, 2014
Citation: Christian E, Huang C, Yen C, Acosta FA, Chen TC, et al. (2014) A Modified Gaines Approach for Lumbosacral Traumatic Spondyloptosis: A Historical Review and Case Illustration. J Spine 3:174. doi:10.4172/2165-7939.1000174
Copyright: © 2014 Christian E, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Spondyloptosis is defined as greater than 100% subluxation of one vertebra over another; it most commonly develops due to dysplastic spondyloslisthesis but can also develop as a result of traumatic fracture-dislocations. In the past, given the significant force associated with this injury, most patients did not survive the initial trauma and resuscitation. However, as early care of patients with multiple traumatic injuries continues to improve, a larger number of patients with traumatic spondyloptosis will require treatment. In general, the goals of surgical intervention are to treat symptoms, preserve and improve neurologic status, restore and maintain sagittal balance, and obtain a solid arthrodesis while fusing as few segments as possible. There is, however, considerable controversy about specific surgical management in achieving these goals. We present a case of traumatic spondyloptosis including a discussion of our surgical approach, which is a modified Gaines procedure with a corpectomy, interbody fusion, and posterior spinal decompression and fusion. Alternate approaches are also discussed from both our institutional experience and from a review of the current literature.

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