Repair of spondylolysis using a rod-screw construct

ABSTRACT

To assess the results of a technique of internal fixation consisting of pedicle screws and a V-shaped rod resting against the inferior aspect on the spinous process and the posterior aspects of the laminas and post operative bracing and rehabilitation programs. Twelve Patients with painful pars defect not responding to conservative treatment were considered to be eligible for direct repair of their spondylolysis. The surgical technique involved placement of screws on the pedicles of the involved vertebra and the fixation of the loose posterior arch with a solid rod bent in a V shape, taking purchase on the spinous process and laminae. A bone graft was placed under compression in the pars defect and postoperative bracing and rehabilitation programs were carried out. Nine patients had an excellent result, returned to normal every day life and work. The outcome in one patient was rated good and in one, fair. The procedure in one was considered a failure, although bone fusion seemed to have been obtained. No complications were encountered because of the specific design of the construct. This technique offers the advantage of being easy and fast, it can be performed using available spinal instrumentations using rods and pedicle screws. It avoids penetration of the spinal canal. This technique seems safe and effective but needs careful selection of patients. Post operative bracing and rehabilitation programs have very important role in follow up and improvement of our patients with good results: