Direct Repair of Symptomatic Lumbar Spondylolysis Using Rod-Screw-Cable System

To assess the efficacy of a new direct lysis repair technique using internal fixation with rod, screws, and Songer cable in symptomatic lumbar spondylolysis. Between December 2015 and January 2020, patients who were diagnosed with symptomatic lumbar spondylolysis and surgically treated with a rod-sc...

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Bibliographic Details
Published in:World neurosurgery 2024-03, Vol.183, p.e625-e631
Main Authors: Kim, Dae-Yong, Jin, Sang-Ryul, Hur, Sung-Min, Chung, Ji-Hun, Lee, Seung Myung, Kim, Pius
Format: Article
Language:English
Subjects:
Bone Screws
Direct repair
Female
Humans
Internal Fixators
Lumbar spondylolysis
Lumbar Vertebrae - diagnostic imaging
Lumbar Vertebrae - surgery
Lytic spondylolisthesis
Male
Middle Aged
Pars defect
Rod-screw-cable system
Spinal Fusion - methods
Spondylolysis - complications
Spondylolysis - diagnostic imaging
Spondylolysis - surgery
Treatment Outcome
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Summary:To assess the efficacy of a new direct lysis repair technique using internal fixation with rod, screws, and Songer cable in symptomatic lumbar spondylolysis. Between December 2015 and January 2020, patients who were diagnosed with symptomatic lumbar spondylolysis and surgically treated with a rod-screw-cable system were recruited. Pedicle screwing by the Magerl technique was performed in all included patients, followed by direct lysis repair with bone allograft and demineralized bone matrix by stabilizing the posterior lamina and spinous process using a rod-screw-cable system. Clinical outcome was measured using the visual analog scale and Oswestry disability index preoperatively and 6 weeks, 3 months, 6 months, 1 year, and 2 years postoperatively. Sixteen patients were included in this study—11 men and 5 women (mean age: 47 years; range, 26–67 years). The lytic defects were at L4 and L5 in 6 and 10 patients, respectively. The mean follow-up period was 41 months (24–62 months). The visual analog scale values were 7.3, 6.1, 4.3, 3.3, 2.1, and 1.9 preoperatively and 6 weeks, 3 months, 6 months, 1 year, and 2 years postoperatively, respectively. The Oswestry disability index values were 59.8%, 55.4%, 41.7%, 32.4%, 21.1%, and 16.9% for the same periods, respectively. No patient had an increase in the slip after surgery. There were no significant complications such as implant failure. Our technique provides rigid intra-segmental repair of spondylolysis without intersegmental motion interference, even if the patient is older or has disc degeneration.
ISSN:1878-8750
1878-8769
1878-8769
DOI:10.1016/j.wneu.2023.12.155