CLINICAL RESEARCH PROGRESS OF DIRECT SURGICAL REPAIR OF LUMBAR SPONDYLOLYSIS IN YOUNG PATIENTS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIU Haichao , QIAN Jixian.

Department of Orthopedics, Tangdu Hospital, the Fourth Military Medical University, Xi’an Shaanxi, 710038, P.R.China. Corresponding author: QIAN Jixian, E-mail: qianjixian@gmail.com;

Corresponding author：

Keywords：

Young patient; Lumbar spondylolysis; Direct surgical repair

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Objective To review and summarize the surgical techniques and their outcomes for the treatment of lumbar spondylolysis in young patients by direct surgical repair. Methods Both home and abroad literature on the surgical techniques and their outcomes respectively for the treatment of lumbar spondylolysis in young patients by direct surgical repair was reviewed extensively and summarized. Results Direct surgical repair of lumbar spondylolysis can offer a simple reduction and fixation for the injured vertebra, which is also in accord with normal anatomy and physiology. In this way, normal anatomy of vertebra can be sustained. As reported surgical techniques of direct repair, such as single lag screw, hook screw, cerclage wire, pedicle screw cable, pedicle screw rod, and pedicle screw hook system, they all can provide acceptable results for lumbar spondylolysis in young patients. Furthermore, to comply strictly with the inclusion criteria of surgical management and select the appropriate internal fixation can also contribute to a good effectiveness. Within the various methods of internal fixation, pedicle screw hook system has been widely recognized. Conclusion Pedicle screw hook system fixation is simple and safe clinically. With the gradual improvement of this method and the development of minimally invasive technologies, it will have broad application prospects.

Citation： LIU Haichao,QIAN Jixian.. CLINICAL RESEARCH PROGRESS OF DIRECT SURGICAL REPAIR OF LUMBAR SPONDYLOLYSIS IN YOUNG PATIENTS. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(1): 106-109. doi: Copy

1.	Kim HJ, Green DW. Spondylolysis in the adolescent athlete. Curr Opin Pediatr, 2011, 23(1): 68-72.
2.	Gurd DP. Back pain in the young athlete. Sports Med Arthrosc, 2011, 19(1): 7-16.
3.	Schlenzka D, Remes V, Helenius I, et al. Direct repair for treatment of symptomatic spondylolysis and low-grade isthmic spondylolisthesis in young patients: no benefit in comparison to segmental fusion after a mean follow-up of 14.8 years. Eur Spine J, 2006, 15(10): 1437-1447.
4.	Wilms GE, Willems E, Demaerel P, et al. CT volumetry of lumbar vertebral bodies in patients with hypoplasia L5 and bilateral spondylolysis and in normal controls. Neuroradiology, 2012, 54(8): 839-843.
5.	Sairyo K, Sakai T, Mase Y, et al. Painful lumbar spondylolysis among pediatric sports players: a pilot MRI study. Arch Orthop Trauma Surg, 2011, 131(11): 1485-1489.
6.	Zukotynski K, Curtis C, Grant FD, et al. The value of SPECT in the detection of stress injury to the pars interarticularis in patients with low back pain. J Orthop Surg Res, 2010, 5: 13.
7.	Kimura M. My method of filing the lesion with spongy bone in spondylolysis and spondylolistesis . Seikei Geka, 1968, 19(4): 285-296.
8.	Buck JE. Direct repair of the defect in spondylolisthesis. Preliminary report. J Bone Joint Surg (Br), 1970, 52(3): 432-437.
9.	Brennan RP, Smucker PY, Horn EM, et al. Minimally invasive image-guided direct repair of bilateral L-5 pars interarticularis defects. Neurosurg Focus, 2008, 25(2): E13.
10.	Rajasekaran S, Subbiah M, Shetty AP, et al. Direct repair of lumbar spondylolysis by Buck’s technique. Indian J Orthop, 2011, 45(2): 136-140.
11.	Morscher E, Gerber B, Fasel J, et al. Surgical treatment of spondylolisthesis by bone grafting and direct stabilization of spondylolysis by means of a hook screw. Arch Orthop Trauma Surg, 1984, 103(3): 175-178.
12.	Ivanic GM, Pink TP, Achatz W, et al. Direct stabilization of lumbar spondylolysis with a hook screw: mean 11-year follow-up period for 113 patients. Spine (Phila Pa 1976), 2003, 28(3): 255-259.
13.	Nicol RO, Scott JH. Lytic spondylolysis. Repair by wiring. Spine (Phila Pa 1976), 1986, 11(10): 1027-1030.
14.	Nozawa S, Shimizu K, Miyamoto K, et al. Repair of pars interarticularis defect by segmental wire fixation in young athletes with spondylolysis. Am J Sports Med, 2003, 31(3): 359-364.
15.	Askar Z, Wardlaw D, Koti M, et al. Scott wiring for direct repair of lumbar spondylolysis. Spine (Phila Pa 1976), 2003, 28(4): 354-357.
16.	Bozarth GR, Fogel GR, Toohey JS, et al. Repair of pars interarticularis defect with a modified cable-screw construct. J Surg Orthop Adv, 2007, 16(2): 79-83.
17.	Songer MN, Rovin R. Repair of the pars interarticularis defect with a cable-screw construct. A preliminary report. Spine (Phila Pa 1976), 1998, 23(2): 263-269.
18.	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.
19.	Gillet P, Petit M. Direct repair of spondylolysis without spondylolisthesis, using a rod-screw construct and bone grafting of the pars defect. Spine (Phila Pa 1976), 1999, 24(12): 1252-1256.
20.	Altaf F, Osei NA, Garrido E, et al. Repair of spondylolysis using compression with a modular link and screws. J Bone Joint Surg (Br), 2011, 93(1): 73-77.
21.	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.
22.	Noggle JC, Sciubba DM, Samdani AF, et al. Minimally invasive direct repair of lumbar spondylolysis with a pedicle screw and hook construct. Neurosurg Focus, 2008, 25(2): E15.
23.	Debusscher F, Troussel S. Direct repair of defects in lumbar spondylolysis with a new pedicle screw hook fixation: clinical, functional and Ct-assessed study. Eur Spine J, 2007, 16(10): 1650-1658.
24.	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.
25.	Sairyo K, Sakai T, Yasui N, et al. Minimally invasive technique for direct repair of pars interarticularis defects in adults using a percutaneous pedicle screw and hook-rod system. J Neurosurg Spine, 2009, 10(5): 492-495.

1. Kim HJ, Green DW. Spondylolysis in the adolescent athlete. Curr Opin Pediatr, 2011, 23(1): 68-72.
2. Gurd DP. Back pain in the young athlete. Sports Med Arthrosc, 2011, 19(1): 7-16.
3. Schlenzka D, Remes V, Helenius I, et al. Direct repair for treatment of symptomatic spondylolysis and low-grade isthmic spondylolisthesis in young patients: no benefit in comparison to segmental fusion after a mean follow-up of 14.8 years. Eur Spine J, 2006, 15(10): 1437-1447.
4. Wilms GE, Willems E, Demaerel P, et al. CT volumetry of lumbar vertebral bodies in patients with hypoplasia L5 and bilateral spondylolysis and in normal controls. Neuroradiology, 2012, 54(8): 839-843.
5. Sairyo K, Sakai T, Mase Y, et al. Painful lumbar spondylolysis among pediatric sports players: a pilot MRI study. Arch Orthop Trauma Surg, 2011, 131(11): 1485-1489.
6. Zukotynski K, Curtis C, Grant FD, et al. The value of SPECT in the detection of stress injury to the pars interarticularis in patients with low back pain. J Orthop Surg Res, 2010, 5: 13.
7. Kimura M. My method of filing the lesion with spongy bone in spondylolysis and spondylolistesis . Seikei Geka, 1968, 19(4): 285-296.
8. Buck JE. Direct repair of the defect in spondylolisthesis. Preliminary report. J Bone Joint Surg (Br), 1970, 52(3): 432-437.
9. Brennan RP, Smucker PY, Horn EM, et al. Minimally invasive image-guided direct repair of bilateral L-5 pars interarticularis defects. Neurosurg Focus, 2008, 25(2): E13.
10. Rajasekaran S, Subbiah M, Shetty AP, et al. Direct repair of lumbar spondylolysis by Buck’s technique. Indian J Orthop, 2011, 45(2): 136-140.
11. Morscher E, Gerber B, Fasel J, et al. Surgical treatment of spondylolisthesis by bone grafting and direct stabilization of spondylolysis by means of a hook screw. Arch Orthop Trauma Surg, 1984, 103(3): 175-178.
12. Ivanic GM, Pink TP, Achatz W, et al. Direct stabilization of lumbar spondylolysis with a hook screw: mean 11-year follow-up period for 113 patients. Spine (Phila Pa 1976), 2003, 28(3): 255-259.
13. Nicol RO, Scott JH. Lytic spondylolysis. Repair by wiring. Spine (Phila Pa 1976), 1986, 11(10): 1027-1030.
14. Nozawa S, Shimizu K, Miyamoto K, et al. Repair of pars interarticularis defect by segmental wire fixation in young athletes with spondylolysis. Am J Sports Med, 2003, 31(3): 359-364.
15. Askar Z, Wardlaw D, Koti M, et al. Scott wiring for direct repair of lumbar spondylolysis. Spine (Phila Pa 1976), 2003, 28(4): 354-357.
16. Bozarth GR, Fogel GR, Toohey JS, et al. Repair of pars interarticularis defect with a modified cable-screw construct. J Surg Orthop Adv, 2007, 16(2): 79-83.
17. Songer MN, Rovin R. Repair of the pars interarticularis defect with a cable-screw construct. A preliminary report. Spine (Phila Pa 1976), 1998, 23(2): 263-269.
18. 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.
19. Gillet P, Petit M. Direct repair of spondylolysis without spondylolisthesis, using a rod-screw construct and bone grafting of the pars defect. Spine (Phila Pa 1976), 1999, 24(12): 1252-1256.
20. Altaf F, Osei NA, Garrido E, et al. Repair of spondylolysis using compression with a modular link and screws. J Bone Joint Surg (Br), 2011, 93(1): 73-77.
21. 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.
22. Noggle JC, Sciubba DM, Samdani AF, et al. Minimally invasive direct repair of lumbar spondylolysis with a pedicle screw and hook construct. Neurosurg Focus, 2008, 25(2): E15.
23. Debusscher F, Troussel S. Direct repair of defects in lumbar spondylolysis with a new pedicle screw hook fixation: clinical, functional and Ct-assessed study. Eur Spine J, 2007, 16(10): 1650-1658.
24. 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.
25. Sairyo K, Sakai T, Yasui N, et al. Minimally invasive technique for direct repair of pars interarticularis defects in adults using a percutaneous pedicle screw and hook-rod system. J Neurosurg Spine, 2009, 10(5): 492-495.

Chinese Journal of Reparative and Reconstructive Surgery

CLINICAL RESEARCH PROGRESS OF DIRECT SURGICAL REPAIR OF LUMBAR SPONDYLOLYSIS IN YOUNG PATIENTS

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