Total L-5 spondylectomy and reconstruction of the lumbosacral junction: Technical note

Gary L. Gallia*, Daniel M. Sciubba, Ali Bydon, Ian Suk, Jean Paul Wolinsky, Ziya L. Gokaslan, Timothy F. Witham

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


√The authors describe a technique for total L-5 spondylectomy and reconstruction of the lumbosacral junction. The technique, which involves separately staged posterior and anterior procedures, is reported in two patients harboring neoplasms that involved the L-5 level. The first stage consisted of a posterior approach with removal of all posterior bone elements of L-5 and radical L4-5 and L5-S1 discectomies. Lumbosacral and lumbopelvic instrumentation included pedicle screws as well as iliac screws or a transiliac rod. The second stage consisted of an anterior approach with mobilization of vascular structures, completion of L4-5 and L5-S1 discectomies, and removal of the L-5 vertebral body. Anterior lumbosacral reconstruction included placement of a distractable cage and tension band between L-4 and S-1. Allograft bone was used for fusion in both stages. No significant complications were encountered. At more than 1 year of follow-up, both patients were independently ambulatory, without evidence of recurrent or metastatic disease, and adequate lumbosacral alignment was maintained. The authors conclude that this technique can be safely performed in appropriately selected patients with neoplasms involving L-5.

Original languageEnglish (US)
Pages (from-to)103-111
Number of pages9
JournalJournal of Neurosurgery: Spine
Issue number1
StatePublished - Jul 1 2007


  • Lumbar spine
  • Spinal reconstruction
  • Spinal tumor
  • Spondylectomy

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology


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