1. Florence Nightingale Hospital
DIRECT REPAIR OF LUMBAR SPONDYLOLYSIS BY SEGMENTAL PEDICLE SCREW-INFRALAMINAR HOOK CONSTRUCT
Cagatay OZTURK, MD
Ahmet ALANAY, MD
Meric ENERCAN, MD
Selhan KARADERELER, MD
Omer KARATOPRAK, MD
Azmi HAMZAOGLU, MD
Istanbul Spine Center
Florence Nightingale Hospital
Istanbul-TURKEY

2. PURPOSE PATIENT SAMPLE
To analyse the safety and efficacy of direct pars repair by using segmental pedicle screw-infralaminar hook construct.
Twenty patients (16 female and 4 male) who had treated by direct pars repair with segmental pedicular screw-hook fixation and with minimum 2 years follow-up were included in this study.
PATIENT SAMPLE

3. METHODS All patients had spondylolysis with isthmic defect at
L5 (n=18)
L4 (n=2)
Six (30%) of them had grade 1 spondylolysis.
6 patients (30%) had mild scoliosis
3 (15%) had Schuermann kyphosis.
One patient had both scoliosis and Scheuerman kyphosis.
All had low back pain unresponsive to conservative measures for at least 6 months.
None had radiculopathy signs.

4. METHODS
All patients had a preoperative CT scan and magnetic resonance imaging and all had Phirman class I healthy discs at the involved level.
All patients had CT scans at the postoperative 1 year follow-up to evaluate healing.
Two-year follow-up x-rays were analysed in terms of disc degeneration and collapse at the operated level and progression of existing deformities.

5. Hook-pedicle screw fixation (Tokuhashi technique) (1996)
Exposure of pars defect
Removal of fibrous tissue
Placement of pedicle screws
Onlay autograft harvested from posterior superior iliac spine
Autograft placement on to the defect
Placement of infralaminar hooks
Rod fixation and compression

6. RK, 14y, F

7. RK, 14y, F
Right
Left

8. RESULTS The mean follow-up period was 34.8 (range; 24 to 72) months.
Mean age was 16.8 (range; 14 to 18) years.
CT scan revealed succesfull healing in all patients.
None of the patients had degenerative findings at the disc level below the pars defect.

9. CONCLUSION
Surgical treatment of adolescent patients with spondylolysis by using pedicle screw-infralaminar hook technique resulted with satisfactory clinical and radiological outcome.

10. THANK YOU