Lumbar Spondylolysis Reconstruction-Stabilization Using a Motion-Preserving Technique.

Abstract

Conservative methods are the traditional options in the management of lumber spondylolysis whereas surgery is indicated for symptomatic patients not responding to medical treatment and cases with a multilevel pars defect. The aim of this prospective study was to evaluate the clinical, functional, and radiologic results of using bone graft and fixation with pedicular screw-rod-laminar hook construct in treatment of lumber spondylolysis. Between October 2017 and January 2020, 20 patients with symptomatic lumbar spondylolysis not responding to conservative treatment for more than 6 months were treated by defect reconstruction fixation using bone block autografting and pedicular screw laminar hook construct. The mean follow-up time was 12.5 ± 03.5 months. All patients were examined pre- and postoperatively and followed up clinically (pain [visual analog scale]), functionally (Oswestry Disability Index, Modified Prolo Functional Economic Scales, and Macnab criteria), and radiologically (pars defect healing). Perioperative outcomes and complications were documented. Clinical, radiologic, and functional outcomes were significantly improved. Bony union was evident in all patients (100%). Blood loss, operative time, and hospital stay increased in cases with a multilevel pars defect and cases with associated injuries. Two cases reported complications in this study as misplaced pedicular screw and superficial wound infection. Reconstruction fixation of pars defect using this construct is an effective, feasible procedure in the treatment of Lumbar spondylolysis regarding the preservation of lumbar motion and avoidance of adjacent-segment problems after fusion.