Repair of spondylolysis using a pedicle screw U-shaped rod construct: A preliminary study of 25 young patients with a mean follow-up of 24 months.

Abstract

STUDY DESIGN:

Prospective case series, therapeutic Level IV.

OBJECTIVES:

Functional and radiographic outcome evaluation of patients with spondylolysis treated with pars interarticularis defect repair with iliac bone grafting and application of a construct consisting of a pair of polyaxial pedicle screws connected by a U-shaped rod passing beneath the spinous process.

METHODS:

Twenty-five patients (27 operated lumbar levels) with an average of 20 months of follow-up (range 12-24 m) with spondylolysis who met our inclusion criteria were treated with the above-mentioned technique. Functional assessment was by the Visual Analog Score (VAS) for low back pain (LBP) and Oswestry Disability Index (ODI). Fusion was confirmed with plain x-rays and when indicated with computed tomography scan. Return to activities of daily living (ADL) was also assessed.

RESULTS:

There were 16 males (64%) and 9 females (36%), with a mean age of 18 ± 3 years at surgery, with a mean operating time of 79 ± 13 min and a mean blood loss of 186 ± 57 ml. ODI significantly improved from a mean of 63 ± 7 preoperatively to 10 ± 4 at 12 months postoperatively (P < 0.001). The mean preoperative LBP VAS score 8 ± 1 showed also a statistically significant decrease of values to 1 ± 1 at 12 months, (P < 0.001). At 12 m, all patients returned to unrestricted ADL. Pars healing was present in 19 patients (76%) at 6 months and in all patients at 12 months.

CONCLUSIONS:

Polyaxial pedicular screws with a U-shaped rod offer an effective and reproducible treatment for spondylolysis with an appropriate fusion rate, predictable return to daily activities, and good pain relief in young adults.

• Authors: Ahmed Samir Barakat, Wessam Samir Soliman, Amr Farahat Elgharabawy, Khaled Fawaz, Nader M Diab, Wissam Gaber Alinani, Akram Azzam, Ahmed Maher Sultan
• Journal: Journal of craniovertebral junction & spine (J Craniovertebr Junction Spine) 2021 Apr-Jun Vol. 12 Issue 2 Pg. 170-177 ISSN: 0974-8237 [Print] India
• PMID: 34194164 (Publication Type: Journal Article)
• Copyright: Copyright: © 2021 Journal of Craniovertebral Junction and Spine.