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Uploaded byProf. Dr. Mohamed Mohi Eldin
Lysis repair a new surgical approach
This document discusses a surgical technique for treating lumbar spondylolysis using pedicle screw fixation and bone grafting. The technique involves placing two top-loading titanium pedicle screws across the pars defect bilaterally to simplify screw placement and allow minimal dissection. Postoperative imaging showed excellent bridging of the defect zone and good clinical outcomes, with patients returning quickly to full activity without pain. The technique is recommended for fusion of pars defects and restoration of normal motion in young patients under 30 with isolated back pain and no neurological deficits or spondylolisthesis.
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Lysis repair a new surgical approach
- 1. Mohamed Mohi Eldin Professorof Neurosurgery Cairo University Egypt
- 3. Repetitive stress onpars (isthmus) Loading and unloading (repetitive spinal motion) flexion extension rotation during physical activity.
- 4. Bilateral acute pars fractureswith hazy irregular edges Bilateral chronic pars fracture with well-corticated edges & spina bifida occulta
- 6. 6-month follow-up showing partialbony union 1-year follow-up showing complete bony union
- 16. Using 4.5 mmcortical screws and cancellous bone grafting
- 27. Young patients back painalone No neurological deficits Failure of conservative treatment Pars block test Significant pain relief from wearing a plaster-corset
- 29. We have accepteda forward slip of not more than 2mm as seen on lateral standing roentgenograms
- 33. A standardized fluoroscopicallyguided protocol Don’t violate the facet capsule Defect localized bilaterally Two top-loading titanium pedicle screws, one into each pedicle, at the same level as the pars defect.
- 34. Simplifies visualization requiredfor screw placement allows minimal skin and muscle dissection
- 38. Postoperative X-ray showexcellent over- bridging of the defect zone, confirmed by CT. The clinical outcome seems to be good.
- 39. More stiffness toflexion loads, Larger area available for bone grafting, Less need for postoperative immobilization.
- 41. Fast return tofull activity No postoperative pain No late breakdowns in non-sporting patients.
- 42. Fusion of thepars defect and Restoration of normal motion in patients with lumbar spondylolysis
- 43. When there isno evidence of frank spondylolisthesis or pain does not radiate below the knee In patients younger than 30 years of age.