Pars Repair in Isthmic Spondylolysis in the Young Adults

Background Data: Spondylolysis remains the commonest identifiable cause of low back pain in children and adolescents. Isthmic spondylolysis occurs most commonly at L5. Both repetitive trauma and inherent genetic weakness can make an individual more susceptible to spondylolysis. There are varieties o...

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Autores principales:	Amr M Madkour, MD., Tamer E Metwally, MD., Mohamed M Agamy, MD.
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2019
Materias:	spondylolysis pars repair isthmic spondylolisthesis lumbar spine roland-morris disability questionnaire Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/750146640fd447dfa29ee57867603ac2
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spelling	oai:doaj.org-article:750146640fd447dfa29ee57867603ac22021-12-02T10:11:14ZPars Repair in Isthmic Spondylolysis in the Young Adults10.21608/esj.2019.12979.11022314-89502314-8969https://doaj.org/article/750146640fd447dfa29ee57867603ac22019-06-01T00:00:00Zhttps://www.esj.journals.ekb.eg/article_75850.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: Spondylolysis remains the commonest identifiable cause of low back pain in children and adolescents. Isthmic spondylolysis occurs most commonly at L5. Both repetitive trauma and inherent genetic weakness can make an individual more susceptible to spondylolysis. There are varieties of surgical treatments to spondylolysis whether surgical fusion or pars repair in patients with no evident slippage or disc degeneration. Purpose: To evaluate the efficacy of pars repair in patients with spondylolysis in regard to pain improvement and fusion. Study Design: Prospective case series study. Patients and Methods: Ten cases with isthmic spondylolysis were reported in this study. Between January 2016 and December 2018, three males and seven females were recruited. Inclusion criteria were as follows: age <30 years; weight <80 kg; back pain not responding to conservative treatment; slippage <2 mm; healthy disc space; no previous operation; and preserved lumbar lordosis. All patients underwent direct pars repair surgery using smiley face-shaped rod technique (V-shaped rod technique) with iliac crest bone graft. All patients were examined clinically and radiologically at 6 and 12 months after surgery to assess back pain using Roland-Morris Disability Questionnaire (RMQ) and fusion by plain radiographs and MS-CT of lumbosacral spine. Results: Good outcome was achieved in seven cases (70% of patients) with significant improvement in back pain, RMQ; radiologically, sound pars fusion was shown. Two cases (20% of patients) had fair outcome and sound pars fusion with occasional back pain occurring with sports and strenuous activities with sound pars fusion. One case (10% of patients) had poor outcome as there was no fusion radiologically with poor improvement in RMQ and underwent traditional surgery with 4 screws, 2 rods, and cage placement. Conclusion: Direct pars repair with V-shaped rod technique provides good functional outcomes in young adult patients with isthmic spondylolysis and can be an alternative method for traditional fusion. (2019ESJ180) Amr M Madkour, MD.Tamer E Metwally, MD.Mohamed M Agamy, MD.Egyptian Spine Associationarticlespondylolysispars repairisthmic spondylolisthesislumbar spineroland-morris disability questionnaireNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 31, Iss 1, Pp 27-35 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	spondylolysis pars repair isthmic spondylolisthesis lumbar spine roland-morris disability questionnaire Neurology. Diseases of the nervous system RC346-429
spellingShingle	spondylolysis pars repair isthmic spondylolisthesis lumbar spine roland-morris disability questionnaire Neurology. Diseases of the nervous system RC346-429 Amr M Madkour, MD. Tamer E Metwally, MD. Mohamed M Agamy, MD. Pars Repair in Isthmic Spondylolysis in the Young Adults
description	Background Data: Spondylolysis remains the commonest identifiable cause of low back pain in children and adolescents. Isthmic spondylolysis occurs most commonly at L5. Both repetitive trauma and inherent genetic weakness can make an individual more susceptible to spondylolysis. There are varieties of surgical treatments to spondylolysis whether surgical fusion or pars repair in patients with no evident slippage or disc degeneration. Purpose: To evaluate the efficacy of pars repair in patients with spondylolysis in regard to pain improvement and fusion. Study Design: Prospective case series study. Patients and Methods: Ten cases with isthmic spondylolysis were reported in this study. Between January 2016 and December 2018, three males and seven females were recruited. Inclusion criteria were as follows: age <30 years; weight <80 kg; back pain not responding to conservative treatment; slippage <2 mm; healthy disc space; no previous operation; and preserved lumbar lordosis. All patients underwent direct pars repair surgery using smiley face-shaped rod technique (V-shaped rod technique) with iliac crest bone graft. All patients were examined clinically and radiologically at 6 and 12 months after surgery to assess back pain using Roland-Morris Disability Questionnaire (RMQ) and fusion by plain radiographs and MS-CT of lumbosacral spine. Results: Good outcome was achieved in seven cases (70% of patients) with significant improvement in back pain, RMQ; radiologically, sound pars fusion was shown. Two cases (20% of patients) had fair outcome and sound pars fusion with occasional back pain occurring with sports and strenuous activities with sound pars fusion. One case (10% of patients) had poor outcome as there was no fusion radiologically with poor improvement in RMQ and underwent traditional surgery with 4 screws, 2 rods, and cage placement. Conclusion: Direct pars repair with V-shaped rod technique provides good functional outcomes in young adult patients with isthmic spondylolysis and can be an alternative method for traditional fusion. (2019ESJ180)
format	article
author	Amr M Madkour, MD. Tamer E Metwally, MD. Mohamed M Agamy, MD.
author_facet	Amr M Madkour, MD. Tamer E Metwally, MD. Mohamed M Agamy, MD.
author_sort	Amr M Madkour, MD.
title	Pars Repair in Isthmic Spondylolysis in the Young Adults
title_short	Pars Repair in Isthmic Spondylolysis in the Young Adults
title_full	Pars Repair in Isthmic Spondylolysis in the Young Adults
title_fullStr	Pars Repair in Isthmic Spondylolysis in the Young Adults
title_full_unstemmed	Pars Repair in Isthmic Spondylolysis in the Young Adults
title_sort	pars repair in isthmic spondylolysis in the young adults
publisher	Egyptian Spine Association
publishDate	2019
url	https://doaj.org/article/750146640fd447dfa29ee57867603ac2
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Pars Repair in Isthmic Spondylolysis in the Young Adults

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