Clinical Results of Restoration of Pars Interarticularis Defect in Adults with Percutaneous Intralaminar Screw Fixation

Abstract

This study aims to report the clinical outcomes associated with the percutaneous intralaminar screw repair performed for pars defects in adults. Adult patients who got their lumbar L5 spondylolysis repaired via modified Buck's procedure between 2017 and 2020 were retrospectively evaluated. The preoperative and postoperative clinical outcomes at 1, 3, 6, and 12months were evaluated for patients with and without fusion using the visual analog scale, Oswestry Disability Index, and the Short-Form Health Survey 36 (SF-36). At 12months, the fusion status of all the patients was assessed using bilateral direct X-rays. Thirty patients with spondylolysis were identified (11 men and 19 women). All patients had bilateral L5 pars defects, and at 12months, the fusion rate was 60% (18/30). There was no difference between the fusion and nonfusion groups in terms of their visual analog scale, Oswestry Disability Index, and SF-36 physical component summary and SF-36 mental component summary scores (P>0.05). Within-group comparisons of the 2 groups revealed significant changes at follow-up (P<0.05). Minimally invasive repair of lumbar spondylolysis with percutaneous intralaminar screw fixation restores the motion segment and can provide early resumption of physical activity with minimal muscle damage, smaller skin incision, and less soft tissue dissection.