EFFECTIVENESS OF POSTERIOR INTRASEGMENTAL FIXATION WITH PEDICLE SCREW-LAMINA HOOK SYSTEM IN TREATMENT OF LUMBAR SPONDYLOLYSIS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHOU Zhongjie , SONG Yueming , ZENG Jiancheng , LIU Hao , LIU Limin , KONG Qingquan , LI Tao , GONG Quan.

Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China. Corresponding author: SONG Yueming, E-mail: Sym_cd@yahoo.com.cn;

Corresponding author：

Keywords：

Lumbar spondylolysis; Pedicle screw-lamina hook system; Bone grafting repair

DOI：

10.7507/1002-1892.20130063

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the effectiveness of posterior intrasegmental fixation with pedicle screw-lamina hook system and bone grafting for lumbar spondylolysis. Methods Between January 2005 and October 2009, 22 patients with lumbar spondylolysis underwent posterior intrasegmental fixation with pedicle screw-lamina hook system and bone grafting. There were 19 males and 3 females with an average age of 18.4 years (range, 12-26 years). The main symptom was low back pain with an average disease duration of 16 months (range, 8-56 months). The visual analogue scale (VAS) was 6.0 ± 1.2 and Oswestry disability index (ODI) was 72.0% ± 10.0% preoperatively. The X-ray films showed bilateral spondylolysis at L4 in 9 cases and at L5 in 13 cases. The range of motion (ROM) at upper and lower intervertebral spaces was (11.8 ± 2.8)°and (14.1 ± 1.9)°, respectively. ResultsAll incisions healed by first intention. All patients were followed up 12-45 months (mean, 25 months). Low back pain was significantly alleviated after operation. The VAS score (0.3 ± 0.5) and ODI (17.6% ± 3.4%) were significantly decreased at last follow-up when compared with preoperative scores (P lt; 0.05). CT showed bone graft fusion in the area of isthmus defects, with no loosening or breaking of internal fixator. At last follow-up, the lateral flexion-extension X-ray films of the lumbar spine showed that the ROM at upper and lower intervertebral spaces was (12.3 ± 2.1)°and (13.5 ± 1.7)°, respectively; showing significant differences when compared with preoperative values (P lt; 0.05). Pain at donor site of iliac bone occurred in 1 case, and was cured after pain release treatment. ConclusionThe posterior intrasegmental fixation with pedicle screw-lamina hook system and bone grafting is a reliable treatment for lumbar spondylolysis, having a high fusion rate, low complication rate, and maximum retention of lumbar ROM.

Citation： ZHOU Zhongjie,SONG Yueming,ZENG Jiancheng,LIU Hao,LIU Limin,KONG Qingquan,LI Tao,GONG Quan.. EFFECTIVENESS OF POSTERIOR INTRASEGMENTAL FIXATION WITH PEDICLE SCREW-LAMINA HOOK SYSTEM IN TREATMENT OF LUMBAR SPONDYLOLYSIS. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(3): 274-277. doi: 10.7507/1002-1892.20130063 Copy

1.	Ghiselli G, Wang JC, Bhatia NN, et al. Adjacent segment degeneration in the lumbar spine. J Bone Joint Surg (Am), 2004, 86-A(7): 1497-1503.
2.	Fan J, Yu GR, Liu F, et al. A biomechanical study on the direct repair of spondylolysis by different techniques of fixation. Orthop Surg, 2010, 2(1): 46-51.
3.	Fan J, Yu GR, Liu F, et al. Direct repair of spondylolysis by TSRH’s hook plus screw fixation and bone grafting: biomechanical study and clinical report. Arch Orthop Trauma Surg, 2010, 130(2): 209-215.
4.	Radcliff KE, Kalantar SB, Reitman CA. Surgical management of spondylolysis and spondylolisthesis in athletes: indications and return to play. Curr Sports Med Rep, 2009, 8(1): 35-40.
5.	Giudici F, Minoia L, Archetti M, et al. Long-term results of the direct repair of spondylolisthesis. Eur Spine J, 2011, 20 Suppl 1: S115-120.
6.	Kim YT, Lee H, Lee CS, et al. Direct repair of the pars interarticularis defect in spondylolysis. J Spinal Disord Tech, 2012. [Epub ahead of print].
7.	Patel RD, Rosas HG, Steinmetz MP, et al. Repair of pars interarticularis defect utilizing a pedicle and laminar screw construct: a new technique based on anatomical and biomechanical analysis. J Neurosurg Spine, 2012, 17(1): 61-68.
8.	Tokuhashi Y, Matsuzaki H. Repair of defects in spondylolysis by segmental pedicular screw hook fixation. A preliminary report. Spine (Phila Pa 1976), 1996, 21(17): 2041-2045.
9.	Deguchi M, Rapoff AJ, Zdeblick TA. Biomechanical comparison of spondylolysis fixation techniques. Spine (Phila Pa 1976), 1999, 24(4): 328-333.
10.	Sairyo K, Sakai T, Yasui N. Conservative treatment of lumbar spondylolysis in childhood and adolescence: the radiological signs which predict healing. J Bone Joint Surg (Br), 2009, 91(2): 206-209.
11.	Dunn AJ, Campbell RS, Mayor PE, et al. Radiological findings and healing patterns of incomplete stress fractures of the pars interarticularis. Skeletal Radiol, 2008, 37(5): 443-450.
12.	Sakai T, Sairyo K, Suzue N, et al. Incidence and etiology of lumbar spondylolysis: review of the literature. J Orthop Sci, 2010, 15(3): 281-288.
13.	Mohi Eldin M. Minimal access direct spondylolysis repair using a pedicle screw-rod system: a case series. J Med Case Rep, 2012, 6(1): 396.
14.	Roca J, Iborra M, Cavanilles-Walker JM, et al. Direct repair of spondylolysis using a new pedicle screw hook fixation: clinical and CT-assessed study: an analysis of 19 patients. J Spinal Disord Tech, 2005, 18 Suppl: S82-89.
15.	Zhao J, Liu F, Shi HG, et al. Biomechanical and clinical study on screw hook fixation after direct repair of lumbar spondylolysis. Chin J Traumatol, 2006, 9(5): 288-292.
16.	Ulibarri JA, Anderson PA, Escarcega T, et al. Biomechanical and clinical evaluation of a novel technique for surgical repair of spondylolysis in adolescents. Spine (Phila Pa 1976), 2006, 31(18): 2067-2072.

1. Ghiselli G, Wang JC, Bhatia NN, et al. Adjacent segment degeneration in the lumbar spine. J Bone Joint Surg (Am), 2004, 86-A(7): 1497-1503.
2. Fan J, Yu GR, Liu F, et al. A biomechanical study on the direct repair of spondylolysis by different techniques of fixation. Orthop Surg, 2010, 2(1): 46-51.
3. Fan J, Yu GR, Liu F, et al. Direct repair of spondylolysis by TSRH’s hook plus screw fixation and bone grafting: biomechanical study and clinical report. Arch Orthop Trauma Surg, 2010, 130(2): 209-215.
4. Radcliff KE, Kalantar SB, Reitman CA. Surgical management of spondylolysis and spondylolisthesis in athletes: indications and return to play. Curr Sports Med Rep, 2009, 8(1): 35-40.
5. Giudici F, Minoia L, Archetti M, et al. Long-term results of the direct repair of spondylolisthesis. Eur Spine J, 2011, 20 Suppl 1: S115-120.
6. Kim YT, Lee H, Lee CS, et al. Direct repair of the pars interarticularis defect in spondylolysis. J Spinal Disord Tech, 2012. [Epub ahead of print].
7. Patel RD, Rosas HG, Steinmetz MP, et al. Repair of pars interarticularis defect utilizing a pedicle and laminar screw construct: a new technique based on anatomical and biomechanical analysis. J Neurosurg Spine, 2012, 17(1): 61-68.
8. Tokuhashi Y, Matsuzaki H. Repair of defects in spondylolysis by segmental pedicular screw hook fixation. A preliminary report. Spine (Phila Pa 1976), 1996, 21(17): 2041-2045.
9. Deguchi M, Rapoff AJ, Zdeblick TA. Biomechanical comparison of spondylolysis fixation techniques. Spine (Phila Pa 1976), 1999, 24(4): 328-333.
10. Sairyo K, Sakai T, Yasui N. Conservative treatment of lumbar spondylolysis in childhood and adolescence: the radiological signs which predict healing. J Bone Joint Surg (Br), 2009, 91(2): 206-209.
11. Dunn AJ, Campbell RS, Mayor PE, et al. Radiological findings and healing patterns of incomplete stress fractures of the pars interarticularis. Skeletal Radiol, 2008, 37(5): 443-450.
12. Sakai T, Sairyo K, Suzue N, et al. Incidence and etiology of lumbar spondylolysis: review of the literature. J Orthop Sci, 2010, 15(3): 281-288.
13. Mohi Eldin M. Minimal access direct spondylolysis repair using a pedicle screw-rod system: a case series. J Med Case Rep, 2012, 6(1): 396.
14. Roca J, Iborra M, Cavanilles-Walker JM, et al. Direct repair of spondylolysis using a new pedicle screw hook fixation: clinical and CT-assessed study: an analysis of 19 patients. J Spinal Disord Tech, 2005, 18 Suppl: S82-89.
15. Zhao J, Liu F, Shi HG, et al. Biomechanical and clinical study on screw hook fixation after direct repair of lumbar spondylolysis. Chin J Traumatol, 2006, 9(5): 288-292.
16. Ulibarri JA, Anderson PA, Escarcega T, et al. Biomechanical and clinical evaluation of a novel technique for surgical repair of spondylolysis in adolescents. Spine (Phila Pa 1976), 2006, 31(18): 2067-2072.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF POSTERIOR INTRASEGMENTAL FIXATION WITH PEDICLE SCREW-LAMINA HOOK SYSTEM IN TREATMENT OF LUMBAR SPONDYLOLYSIS

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content