U-Rod and Screw Construct Combined With Iliac Bone Grafting for Direct Repair of Teenager Mid-Lumbar Spondylolysis

Abstract

Background: Spondylolysis is a bony defect of the pars interarticularis that most commonly occurs in the lower lumbar spine. However, the condition is rare in the mid-lumbar region. Here, we report on a new technique that involves the use of a U-rod and pedicle screw with iliac bone grafting for the direct intrasegmental repair of mid-lumbar spondylolysis in a teenager. Case Report: A 17-year-old male presented with complaints of mild low back pain after physical exercise, and the pain had aggravated in the last 3 months. Magnetic resonance imaging did not show compression of the intracanal neural tissue, and the lumbar discs did not demonstrate any obvious degeneration. He was diagnosed with L3 spondylolysis and lumbar sacralization. U-rod and screw construct with iliac bone grafting were used to directly repair the spondylolysis in L3. The low back pain totally disappeared 3 months after the surgery. A computerized tomography scan revealed the normal structure of L3 2 years post-surgically, and the internal fixation was removed 3 years later. Conclusions: This novel technique involving the use of a U-rod and pedicle screw associated with iliac bone grafting for the direct repair of mid-lumbar spondylolysis in the teenager yielded a satisfactory outcome, which was confirmed by favorable clinical and radiographic outcomes after 3 years. Key words: Mid-lumber spondylolysis, U-rod, direct repair