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A Novel Technique for Pars Defect Direct Repair with a Modified Smiley Face Rod for Spondylolysis and Isthmic Spondylolisthesis – Lumbar Fusion

Day Case Lumbar Fusion Surgery

The article discusses a case of pseudarthrotic lumbar spondylolysis, a fatigue fracture of the lamina of the lumbar spine, in adolescent athletes. The study presents a modified smiley face rod technique for the treatment of this condition, which involves placing pedicle screws in the lateral edge of the pedicle and inserting a U-shaped rod between the spinous processes. This technique preserves the erector spinae muscles and the supraspinous ligament, while repairing the pars cleft and achieving bone fusion. The procedure is minimally invasive and suitable for young athletes to avoid future adjacent segment disorders

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

CONCLUSIONS: This is a minimally invasive procedure that can easily achieve bone fusion and should be introduced for patients who are suffering from the symptoms of pseudarthrotic lumbar spondylolysis.

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Spine Surg Relat Res. 2023 Jun 9;7(4):396-401. doi: 10.22603/ssrr.2023-0021. eCollection 2023 Jul 27.ABSTRACTINTRODUCTION: Lumbar spondylolysis is a common fatigue fracture of the pars interarticularis of the lamina of the lumbar spine in adolescent athletes presenting with pars clefts. Some pseudarthrotic lumbar spondylolysis causes low back pain or radiculopathy. This study presents a case of pseudarthrotic,

Spine Surg Relat Res. 2023 Jun 9;7(4):396-401. doi: 10.22603/ssrr.2023-0021. eCollection 2023 Jul 27.

ABSTRACT

INTRODUCTION: Lumbar spondylolysis is a common fatigue fracture of the pars interarticularis of the lamina of the lumbar spine in adolescent athletes presenting with pars clefts. Some pseudarthrotic lumbar spondylolysis causes low back pain or radiculopathy. This study presents a case of pseudarthrotic lumbar spondylolysis that was successfully treated using a modified smiley face rod technique.

TECHNICAL NOTE: We developed a modified smiley face rod technique, which places pedicle screws in the lateral edge of the pedicle to preserve the erector spinae muscles and inserts a U-shaped rod between the spinous processes to preserve the supraspinous ligament. When a U-shaped rod penetrates the interspinous ligament subcutaneously, the resection of the supraspinous ligaments can be avoided. When the screw head is positioned more anterolaterally, a compression force is applied perpendicular to the surface of the pars cleft by rod clamping. This intrasegmental fusion technique preserves the mobile segment and simultaneously repairs the pars cleft. It is less invasive and more appropriate than interbody fusion for young athletes to avoid the possibility of future adjacent segment disorders.

CONCLUSIONS: This is a minimally invasive procedure that can easily achieve bone fusion and should be introduced for patients who are suffering from the symptoms of pseudarthrotic lumbar spondylolysis.

PMID:37636143 | PMC:PMC10447201 | DOI:10.22603/ssrr.2023-0021

The London Spine Unit : best recognised spine clinic in London

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A Novel Technique for Pars Defect Direct Repair with a Modified Smiley Face Rod for Spondylolysis and Isthmic Spondylolisthesis

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Spine Surg Relat Res. 2023 Jun 9;7(4):396-401. doi: 10.22603/ssrr.2023-0021. eCollection 2023 Jul 27.ABSTRACTINTRODUCTION: Lumbar spondylolysis is a common fatigue fracture of the pars interarticularis of the lamina of the lumbar spine in adolescent athletes presenting with pars clefts. Some pseudarthrotic lumbar spondylolysis causes low back pain or radiculopathy. This study presents a case of pseudarthrotic

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