19 Harley St, London, W1G 9QJ, UK

Direct repair of spondylolysis presenting after correction of adolescent idiopathic scoliosis

BACKGROUND CONTEXT: Although spondylolysis is found in 6% of idiopathic scoliosis patients, very little was reported on management of pars defects in this group. These patients with painful spondylolysis are most eligible for direct repair of the defect rather than lumbosacral fusion in an attempt to save motion segments. PURPOSE: The aim of this work was to analyze the clinical and radiologic outcome of pars repair in a group of adolescents who presented after surgical correction of their idiopathic scoliosis. STUDY DESIGN: A prospective nonrandomized study. PATIENT SAMPLE: Ten consecutive patients with spondylolysis presenting after an average of 3 months (range, 2-7 months) from correction of their idiopathic scoliosis with low back pain not responding to conservative therapy and interfering with everyday activities. The mean age at operation was 16 years (range, 14-19 years). OUTCOME MEASURES: Total blood loss, operative time, and hospital stay were recorded. Clinical outcome was assessed by the Oswestry Disability Index (ODI), visual analog scale (VAS), and Scoliosis Research Society (SRS)-22 questionnaire. Fusion of the pars interarticularis was assessed using plain, lateral, and oblique radiographs and a computed tomography (CT) scan. METHODS: The surgical technique consisted of thorough debridement of the defect, impacting the gap created with a tricortical iliac crest graft, and rigid fixation by either pedicle screws and a V-shaped rod (five patients) or a cable-screw construct (five patients). RESULTS: Patients were followed up for an average of 4.5 years (range, 2-7 years). Nine patients had a good-to-excellent result, returned to normal everyday life, and participated in sports when desired. The mean ODI, VAS, and SRS total scores were 11 (range, 0-34), 1.1 (range, 0-2), and 92 (range, 61-108), respectively. Follow-up radiographs and CT scans revealed healing of all defects in nine cases, no signs of disc degeneration in any, and no implant-related complications. CONCLUSIONS: The results of direct repair of spondylolysis in idiopathic scoliosis patients were very satisfactory both clinically and radiologically. Direct repair appears to be a logical alternative to spinal fusion; lumbar spine mobility was preserved, and precocious motion segments were saved with a relatively simple operation

Keywords : Adolescent,Back,Back Pain,blood,complications,Debridement,diagnostic imaging,Female,Humans,Low Back Pain,Lumbar Vertebrae,Male,methods,Motion,Pain,Patients,Prospective Studies,Radiography,Scoliosis,Spinal Fusion,Spine,Spondylolysis,surgery,therapy,Time,Treatment Outcome,Universities,Young Adult,, Repair,Spondylolysis,Presenting,After, botox treatment for migraines

Date of Publication : 2011 Feb

Authors : Koptan WM;ElMiligui YH;ElSharkawi MM;

Organisation : Orthopaedic Department, Faculty of Medicine, Cairo University, Egypt. waelkoptan@yahoo.com

Journal of Publication : Spine J

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21296297

The London Spine Unit : Harley Street UK. Specialists in Cutting Edge Technologies for Spinal Surgery

Make an Appointment 

Trustpilot Reviews
Doctify Reviews
Top Doctor Reviews

Direct repair of spondylolysis presenting after correction of adolescent idiopathic scoliosis | Rsi pain

What our patients say ...

Consultant Spine Surgeon
Consultant Spine Surgeon
Consultant Spine Surgeon

This surgical technique consists of a percutaneous approach for the treatment of small to medium size hernias of the intervertebral disc by laser energy. The main objective is to reduce the intradiscal pressure in the nucleus pulposus

Laser Disc Surgery can be performed under local anaesthetic as a day case at our centre on the prestigious Harley Street.
What is London spine unit and How it Works

The London Spine Unit was established in 2005 and has successfully treated over 5000 patients. All conditions are treated.

treatment of all spinal disorders

The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function

Trusted by patients worldwide

The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810