Spondylolysis Pars Repair

Spondylolysis Pars Repair

Spondylolysis is a known spinal condition affecting up to 15% of the population in which a vertebrae has a definable fracture or crack in a segment of bone known as the pars interarticularis.

This is not a congenital condition, but rather acquired, appearing at the age ofxray-1[1] fiveand upwards. Athletes, in particular gymnasts, are susceptible because of the extreme stresses they place on their spine, particularly in hyperextension.

Most spondylolysis can be detected via x-ray and in certain cases a CAT scan or MRI is necessary as an adjunct study, and most can be managed with conservative management in the way of anti-inflammatory medications, cessation of painful activities, brace treatment, and occasionally injections.

xray-2[1]When the back pain is not relieved by those treatments, or if pain begins to radiate to the legs because of nerve irritation as the body attempts a primitive repair of the lysis or fracture, then surgery may be warranted. Basic surgeries include either a fusion surgery, which would attempt to fuse one bone to the next, or a direct repair.

Direct repair is more often performed in a younger population in which there is no disc or shock absorber disease at the level of the spine or in adjacent levels.

Two common techniques include a screw and hook compression technique or a direct screw repair technique.

At the Center for Spinal Disorders, we have had significant success, particularly using the screw and hook compression technique. Enclosed is one of our X-rays on a recent 16-year-old basketball athlete who had a painful pars spondylolysis at L5 disc lumbar vertebrae for over a year with failed conservative management.

Please let us know if we can help you in deciding on the appropriate treatment for your spondylolysis.

Jonathan Lewin, MD, August 25, 2015n

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