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V-rod technique for direct repair surgery of pediatric lumbar spondylolysis combined with posterior apophyseal ring fracture.

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V-rod technique for direct repair surgery of pediatric lumbar spondylolysis combined with posterior apophyseal ring fracture.

Asian Spine J. 2013 Jun;7(2):115-8

Authors: Sumita T, Sairyo K, Shibuya I, Kitahama Y, Kanamori Y, Matsumoto H, Koga S, Kitagawa Y, Dezawa A

Abstract
We report a pediatric baseball player having both a fracture of the posterior ring apophysis and spondylolysis. He was presented to a primary care physician complaining of back pain and leg pain. Despite conservative treatment for 3 months, the pain did not subside. He was referred to our clinic, and surgical intervention was carried out. First, a bony fragment of the caudal L5 apophyseal ring was removed following fenestration at the L5-S interlaminal space, bilaterally: and decompression of the bilateral S1 nerve roots was confirmed. Next, pseudoarthrosis of the L5 pars was refreshed and pedicle screws were inserted bilaterally. A v-shaped rod was inserted beneath the L5 spinous process, which stabilized the pars defects. After the surgery, back pain and leg pain completely disappeared. In conclusion, the v-rod technique is appropriate for the spondylolysis direct repair surgery, especially, in case the loose lamina would have a partial laminotomy.

PMID: 23741549 [PubMed – in process]

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