Abstract
Introduction
Spondylolysis is a common problem affecting all ages but in adolescent and young adult specially the athletes it represent a significant dilemma as most of them starting their life and need a stable free spine, a minority of old people affected by this disease need medical care, and only a few require surgery but in athletes and young adult surgery usually the role. Reconstruction of the pars interarticularis is an alternative to segmental fusion; this technique has the advantage of preserving segmental motion. Most authors report good results for young patients without intervertebral disc or facet affection
Material and Methods
In this study the fixation of the isthmus was done with a pedicle screw hook system. This stable and strong device is easy to use, allows an anatomic pars interarticularis reconstruction and avoids a postoperative bracing and allow early ambulation. 9 patients were assessed in this study, the mean age at operation was 24 (range 16–32 years) and the average follow-up was for 24 months (range 6–36 months). 7 patients showed no preoperative degenerative disc disease and 2 patients had grade 1 changes. The visual analogical scale, the Oswestry disability index (ODI were used for assessment of pain and clinical outcome before and after surgery.
Results
The results were from “excellent” to “good” for 8 patients and “fair” for one of them. The fusion rate was observed in all cases. Among patients results are from “good,” to “excellent” in all cases and consolidation was always observed. All of them showed normal disc height after the surgery.
Conclusion
Direct spondylolsis repair by pedicle screw hook system is an excellent and reliable method in management of spondylolysis especially in intact disc in young adults