Minimally invasive direct repair of lumbar spondylolysis with a pedicle screw and hook construct

Noggle, Joseph C.; Sciubba, Daniel M.; Samdani, Amer F.; Anderson, D. Greg; Betz, Randal R.; Asghar, Jahangir

doi:10.3171/foc/2008/25/8/e15

Cited by 42 publications

(36 citation statements)

References 20 publications

(16 reference statements)

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“…Eight studies used pedicle screws with laminar hooks, and 4 studies used pedicle screws with a wiring technique. The proportion of patients with low-grade spondylolisthesis ranged from 5.26% 33 to 100% 7,30,47 in the included studies. While most studies included cases of low-grade spondylolisthesis, the exact proportion of cases was mentioned in only 16 studies.…”

Section: Resultsmentioning

confidence: 99%

“…Analysis of this group showed excellent fusion rates; fusion rates of 100% were noted in several studies. 20,21,25,30,37,47,50 The pooled fusion rate was 90.21%. The pedicle screw group had the lowest pooled complication rate of 12.8%.…”

Section: Pedicle Screw-based Repairsmentioning

confidence: 94%

“…47 In this method, the authors used a pedicle screw to anchor a cable that approximated the pars defect. Other pedicle screw-based methods include using a pedicle screw with laminar hook fixation 30 and using a pedicle screw with a curved rod running under the spinous process to stabilize the pars defect. 1,11 In all of these techniques, the common anchor is the pedicle screw.…”

Section: Pedicle Screw-based Repairsmentioning

confidence: 99%

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A comparison of the techniques of direct pars interarticularis repairs for spondylolysis and low-grade spondylolisthesis: a meta-analysis

Mohammed¹,

Patra²,

Narayan³

et al. 2018

Neurosurgical Focus

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OBJECTIVESpondylosis with or without spondylolisthesis that does not respond to conservative management has an excellent outcome with direct pars interarticularis repair. Direct repair preserves the segmental spinal motion. A number of operative techniques for direct repair are practiced; however, the procedure of choice is not clearly defined. The present study aims to clarify the advantages and disadvantages of the different operative techniques and their outcomes.METHODSA meta-analysis was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The following databases were searched: PubMed, Cochrane Library, Web of Science, and CINAHL (Cumulative Index to Nursing and Allied Health Literature). Studies of patients with spondylolysis with or without low-grade spondylolisthesis who underwent direct repair were included. The patients were divided into 4 groups based on the operative technique used: the Buck repair group, Scott repair group, Morscher repair group, and pedicle screw–based repair group. The pooled data were analyzed using the DerSimonian and Laird random-effects model. Tests for bias and heterogeneity were performed. The I2 statistic was calculated, and the results were analyzed. Statistical analysis was performed using StatsDirect version 2.RESULTSForty-six studies consisting of 900 patients were included in the study. The majority of the patients were in their 2nd decade of life. The Buck group included 19 studies with 305 patients; the Scott group had 8 studies with 162 patients. The Morscher method included 5 studies with 193 patients, and the pedicle group included 14 studies with 240 patients. The overall pooled fusion, complication, and outcome rates were calculated. The pooled rates for fusion for the Buck, Scott, Morscher, and pedicle screw groups were 83.53%, 81.57%, 77.72%, and 90.21%, respectively. The pooled complication rates for the Buck, Scott, Morscher, and pedicle screw groups were 13.41%, 22.35%, 27.42%, and 12.8%, respectively, and the pooled positive outcome rates for the Buck, Scott, Morscher, and pedicle screw groups were 84.33%, 82.49%, 80.30%, and 80.1%, respectively. The pedicle group had the best fusion rate and lowest complication rate.CONCLUSIONSThe pedicle screw–based direct pars repair for spondylolysis and low-grade spondylolisthesis is the best choice of procedure, with the highest fusion and lowest complication rates, followed by the Buck repair. The Morscher and Scott repairs were associated with a high rate of complication and lower rates of fusion.

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Section: Resultsmentioning

confidence: 99%

Section: Pedicle Screw-based Repairsmentioning

confidence: 94%

Section: Pedicle Screw-based Repairsmentioning

confidence: 99%

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A comparison of the techniques of direct pars interarticularis repairs for spondylolysis and low-grade spondylolisthesis: a meta-analysis

Mohammed¹,

Patra²,

Narayan³

et al. 2018

Neurosurgical Focus

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“…6 Other authors have reported using pedicle screws to secure the lamina with either a rod-hook construct or a V-shaped rod under the spinous process. 1,12,29,39 Basic Surgical Technique. A standard midline approach to the lumbar spine is performed with care taken to preserve the multifidi attachment to the lateral capsules of the L4-5 and L5-S1 facet joints (unless pedicle screws will be used) and to keep the supraspinous and interspinous ligaments intact.…”

Section: Overview Of Surgical Techniquesmentioning

confidence: 99%

Direct surgical repair of spondylolysis in athletes: indications, techniques, and outcomes

Drazin¹,

Shirzadi²,

Jeswani³

et al. 2011

FOC

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Object Athletes present with back pain as a common symptom. Various sports involve repetitive hyperextension of the spine along with axial loading and appear to predispose athletes to the spinal pathology spondylolysis. Many athletes with acute back pain require nonsurgical treatment methods; however, persistent recurrent back pain may indicate degenerative disc disease or spondylolysis. Young athletes have a greater incidence of spondylolysis. Surgical solutions are many, and yet there are relatively few data in the literature on both the techniques and outcomes of spondylolytic repair in athletes. In this study, the authors undertook a review of the surgical techniques and outcomes in the treatment of symptomatic spondylolysis in athletes. Methods A systematic review of the MEDLINE and PubMed databases was performed using the following key words to identify articles published between 1950 and 2011: “spondylolysis,” “pars fracture,” “repair,” “athlete,” and/or “sport.” Papers on both athletes and nonathletes were included in the review. Articles were read for data on methodology (retrospective vs prospective), type of treatment, number of patients, mean patient age, and mean follow-up. Results Eighteen articles were included in the review. Eighty-four athletes and 279 nonathletes with a mean age of 20 and 21 years, respectively, composed the population under review. Most of the fractures occurred at L-5 in both patient groups, specifically 96% and 92%, respectively. The average follow-up period was 26 months for athletes and 86 months for nonathletes. According to the modified Henderson criteria, 84% (71 of 84) of the athletes returned to their sports activities. The time intervals until their return ranged from 5 to 12 months. Conclusions For a young athlete with a symptomatic pars defect, any of the described techniques of repair would probably produce acceptable results. An appropriate preoperative workup is important. The ideal candidate is younger than 20 years with minimal or no listhesis and no degenerative changes of the disc. Limited participation in sports can be expected from 5 to 12 months postoperatively.

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“…Direct repair of the injury without arthrodesis and with simple blood irrigation of the focus and external immobilization, or compression with hooks and screws, is the preferred treatment, but cases with spondylolisthesis and significant instability make segmental arthrodesis necessary. 11,[34][35][36] The safe and correct interpretation of the imaging exams is fundamental to a decision on the best type of treatment.…”

Section: Frequency Of Spondylolysis and Chronic Low Back Pain In Younmentioning

confidence: 99%

Frequency of spondylolysis and chronic low back pain in young soccer players

Lima¹,

Júnior²,

Jorge³

et al. 2014

Coluna/Columna

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Objective: To demonstrate the safety of soccer for adolescents in terms of chronic lesions of the lumbar spine, particularly spondylolysis. Methods: 54 young players underwent a pre-season assessment. The athletes were submitted to radiography of the lumbosacral spine. Players complaining of chronic low back pain were later submitted to more specific tests. Results: only 1 athlete (1.85 % of our sample) had complaints of chronic low back pain. In this case, the radiograph showed olisthesis grade I spondylolysis at the L5 level. Conclusion: Soccer proved to be a very safe sport in terms of the risk of developing chronic lesions of the lumbosacral spine. However, the actual incidence of spondylolysis in these athletes was not determined because only plain radiographs were used in this study.Keywords: Low back pain; Athletes; Soccer; Spondylolysis.

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Minimally invasive direct repair of lumbar spondylolysis with a pedicle screw and hook construct

Cited by 42 publications

References 20 publications

A comparison of the techniques of direct pars interarticularis repairs for spondylolysis and low-grade spondylolisthesis: a meta-analysis

A comparison of the techniques of direct pars interarticularis repairs for spondylolysis and low-grade spondylolisthesis: a meta-analysis

Direct surgical repair of spondylolysis in athletes: indications, techniques, and outcomes

Frequency of spondylolysis and chronic low back pain in young soccer players

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