ABSTRACT

Spondyloptosis or grade 5 spondylolisthesis is defined as the forward slippage of the entire L5 vertebral body of S1. Reduction of severe spondylolisthesis continues to be a subject of debate; most authors agree that fusion insitu is a safe and reliable procedure for treatment of high grade spondylolisthesis. Reduction and fixation of L5 on to S1 as described before is a treatment option but it has been noted that the rate of major complications is an acceptably high after reduction or even non reduction procedures. L5 reduction procedures appear to have a distinct instance of L5 root deficits. A method described by Gaines including L5 vertebrectomy, reduction and fusion of L4 on to S1 seems to be more logical because it shortens the spinal canal and nerve roots and peripheral nerves can be re aligned avoiding neurologic deficit. In this case report, two cases of spondyloptosis treated by Gaines procedure were presented with follow-up six years and twelve years.