Direct Repair for Treatment of Lumbar Symptomatic Spondylolysis without Spondylolisthesis in Young Patients Using Gillet Technique (V-Shaped Rod)

Abstract

Introduction Spondylolysis developed during individual growth. In this article, direct repair of the pars defect was used to treat lumbar symptomatic spondylolysis without spondylolisthesis in young patients. Indication and postoperative outcomes of this operation were analyzed, to investigate the method of early treatment of spondylolysis, which can avoid the complication of spinal fusion for delayed isthmic spondylolisthesis caused by spondylolysis. Materials and Methods Twelve cases of lumbar symptomatic spondylolysis were retrospectively reviewed; all the cases received direct repair for the pars defect during 2005 to 2011, and was followed up for at least 2 years. Among them, there are eight cases of male and four cases of female, average 24.5 years old; there are 10 L5 spondylolysis and 4 L4 spondylolysis. They have low back pain and X-ray-confirmed bilateral spondylolysis without spondylolisthesis. There was no disc degeneration on MRI. The operation includes pars debridement, pedicle screw insertion, V-shaped rod connection, and bone autograft. VAS score was used to evaluate the pain status of the patient. Results All the patients got symptoms relieved, VAS score was reduced from 4.8 preoperation to 2.3 postoperation, and they all resumed to original work. During follow-up, the pars defect attained bony union in X-ray and 3D CT scan. Conclusion For the developmental spondylolysis with severe local symptom, but no disc degeneration, direct repair for the pars defect with pedicle screw and V-shaped rod and bone autograft can be used to heal the pars defect. This treatment, which is safe and effective, can reduce occurrence of disc degeneration caused by lumbar instability and delayed spondylolisthesis, avoid complications caused by spinal fusion. Disclosure of Interest None declared