A Novel Technique for Pars Defect Direct Repair with a Modified Smiley Face Rod for Spondylolysis and Isthmic Spondylolisthesis
Introduction: Lumbar spondylolysis is a common fatigue fracture of the pars interarticularis of the lamina of the lumbar spine in adolescent athletes presenting with pars clefts. Some pseudarthrotic lumbar spondylolysis causes low back pain or radiculopathy. This study presents a case of pseudarthro...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The Japanese Society for Spine Surgery and Related Research
2023-07-01
|
| Series: | Spine Surgery and Related Research |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/ssrr/7/4/7_2023-0021/_pdf/-char/en |
| _version_ | 1797659797622882304 |
|---|---|
| author | Masaki Tatsumura Shun Okuwaki Hisarnori Gamada Reo Asai Fumihiko Eto Katsuya Nagashima Yosuke Takeuchi Toru Funayama Masashi Yamazaki |
| author_facet | Masaki Tatsumura Shun Okuwaki Hisarnori Gamada Reo Asai Fumihiko Eto Katsuya Nagashima Yosuke Takeuchi Toru Funayama Masashi Yamazaki |
| author_sort | Masaki Tatsumura |
| collection | DOAJ |
| description | Introduction: Lumbar spondylolysis is a common fatigue fracture of the pars interarticularis of the lamina of the lumbar spine in adolescent athletes presenting with pars clefts. Some pseudarthrotic lumbar spondylolysis causes low back pain or radiculopathy. This study presents a case of pseudarthrotic lumbar spondylolysis that was successfully treated using a modified smiley face rod technique.
Technical Note: We developed a modified smiley face rod technique, which places pedicle screws in the lateral edge of the pedicle to preserve the erector spinae muscles and inserts a U-shaped rod between the spinous processes to preserve the supraspinous ligament. When a U-shaped rod penetrates the interspinous ligament subcutaneously, the resection of the supraspinous ligaments can be avoided. When the screw head is positioned more anterolaterally, a compression force is applied perpendicular to the surface of the pars cleft by rod clamping. This intrasegmental fusion technique preserves the mobile segment and simultaneously repairs the pars cleft. It is less invasive and more appropriate than interbody fusion for young athletes to avoid the possibility of future adjacent segment disorders.
Conclusions: This is a minimally invasive procedure that can easily achieve bone fusion and should be introduced for patients who are suffering from the symptoms of pseudarthrotic lumbar spondylolysis. |
| first_indexed | 2024-03-11T18:20:26Z |
| format | Article |
| id | doaj.art-c673b2d150b1411b88402d4f4baf4b31 |
| institution | Directory Open Access Journal |
| issn | 2432-261X |
| language | English |
| last_indexed | 2024-03-11T18:20:26Z |
| publishDate | 2023-07-01 |
| publisher | The Japanese Society for Spine Surgery and Related Research |
| record_format | Article |
| series | Spine Surgery and Related Research |
| spelling | doaj.art-c673b2d150b1411b88402d4f4baf4b312023-10-16T00:32:24ZengThe Japanese Society for Spine Surgery and Related ResearchSpine Surgery and Related Research2432-261X2023-07-017439640110.22603/ssrr.2023-00212023-0021A Novel Technique for Pars Defect Direct Repair with a Modified Smiley Face Rod for Spondylolysis and Isthmic SpondylolisthesisMasaki Tatsumura0Shun Okuwaki1Hisarnori Gamada2Reo Asai3Fumihiko Eto4Katsuya Nagashima5Yosuke Takeuchi6Toru Funayama7Masashi Yamazaki8Department of Orthopaedic Surgery and Sports Medicine, Tsukuba University Hospital Mito Clinical Education and Training Center, Mito Kyodo General HospitalDepartment of Orthopaedic Surgery, Institute of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Institute of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Institute of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Institute of Medicine, University of TsukubaDepartment of Orthopaedic Surgery and Sports Medicine, Tsukuba University Hospital Mito Clinical Education and Training Center, Mito Kyodo General HospitalDepartment of Orthopaedic Surgery and Sports Medicine, Tsukuba University Hospital Mito Clinical Education and Training Center, Mito Kyodo General HospitalDepartment of Orthopaedic Surgery, Institute of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Institute of Medicine, University of TsukubaIntroduction: Lumbar spondylolysis is a common fatigue fracture of the pars interarticularis of the lamina of the lumbar spine in adolescent athletes presenting with pars clefts. Some pseudarthrotic lumbar spondylolysis causes low back pain or radiculopathy. This study presents a case of pseudarthrotic lumbar spondylolysis that was successfully treated using a modified smiley face rod technique. Technical Note: We developed a modified smiley face rod technique, which places pedicle screws in the lateral edge of the pedicle to preserve the erector spinae muscles and inserts a U-shaped rod between the spinous processes to preserve the supraspinous ligament. When a U-shaped rod penetrates the interspinous ligament subcutaneously, the resection of the supraspinous ligaments can be avoided. When the screw head is positioned more anterolaterally, a compression force is applied perpendicular to the surface of the pars cleft by rod clamping. This intrasegmental fusion technique preserves the mobile segment and simultaneously repairs the pars cleft. It is less invasive and more appropriate than interbody fusion for young athletes to avoid the possibility of future adjacent segment disorders. Conclusions: This is a minimally invasive procedure that can easily achieve bone fusion and should be introduced for patients who are suffering from the symptoms of pseudarthrotic lumbar spondylolysis.https://www.jstage.jst.go.jp/article/ssrr/7/4/7_2023-0021/_pdf/-char/enspondylolysispars defectdirect repairsmiley face rodisthmic spondylolisthesispseudarthrosispars repairtechnical note |
| spellingShingle | Masaki Tatsumura Shun Okuwaki Hisarnori Gamada Reo Asai Fumihiko Eto Katsuya Nagashima Yosuke Takeuchi Toru Funayama Masashi Yamazaki A Novel Technique for Pars Defect Direct Repair with a Modified Smiley Face Rod for Spondylolysis and Isthmic Spondylolisthesis Spine Surgery and Related Research spondylolysis pars defect direct repair smiley face rod isthmic spondylolisthesis pseudarthrosis pars repair technical note |
| title | A Novel Technique for Pars Defect Direct Repair with a Modified Smiley Face Rod for Spondylolysis and Isthmic Spondylolisthesis |
| title_full | A Novel Technique for Pars Defect Direct Repair with a Modified Smiley Face Rod for Spondylolysis and Isthmic Spondylolisthesis |
| title_fullStr | A Novel Technique for Pars Defect Direct Repair with a Modified Smiley Face Rod for Spondylolysis and Isthmic Spondylolisthesis |
| title_full_unstemmed | A Novel Technique for Pars Defect Direct Repair with a Modified Smiley Face Rod for Spondylolysis and Isthmic Spondylolisthesis |
| title_short | A Novel Technique for Pars Defect Direct Repair with a Modified Smiley Face Rod for Spondylolysis and Isthmic Spondylolisthesis |
| title_sort | novel technique for pars defect direct repair with a modified smiley face rod for spondylolysis and isthmic spondylolisthesis |
| topic | spondylolysis pars defect direct repair smiley face rod isthmic spondylolisthesis pseudarthrosis pars repair technical note |
| url | https://www.jstage.jst.go.jp/article/ssrr/7/4/7_2023-0021/_pdf/-char/en |
| work_keys_str_mv | AT masakitatsumura anoveltechniqueforparsdefectdirectrepairwithamodifiedsmileyfacerodforspondylolysisandisthmicspondylolisthesis AT shunokuwaki anoveltechniqueforparsdefectdirectrepairwithamodifiedsmileyfacerodforspondylolysisandisthmicspondylolisthesis AT hisarnorigamada anoveltechniqueforparsdefectdirectrepairwithamodifiedsmileyfacerodforspondylolysisandisthmicspondylolisthesis AT reoasai anoveltechniqueforparsdefectdirectrepairwithamodifiedsmileyfacerodforspondylolysisandisthmicspondylolisthesis AT fumihikoeto anoveltechniqueforparsdefectdirectrepairwithamodifiedsmileyfacerodforspondylolysisandisthmicspondylolisthesis AT katsuyanagashima anoveltechniqueforparsdefectdirectrepairwithamodifiedsmileyfacerodforspondylolysisandisthmicspondylolisthesis AT yosuketakeuchi anoveltechniqueforparsdefectdirectrepairwithamodifiedsmileyfacerodforspondylolysisandisthmicspondylolisthesis AT torufunayama anoveltechniqueforparsdefectdirectrepairwithamodifiedsmileyfacerodforspondylolysisandisthmicspondylolisthesis AT masashiyamazaki anoveltechniqueforparsdefectdirectrepairwithamodifiedsmileyfacerodforspondylolysisandisthmicspondylolisthesis AT masakitatsumura noveltechniqueforparsdefectdirectrepairwithamodifiedsmileyfacerodforspondylolysisandisthmicspondylolisthesis AT shunokuwaki noveltechniqueforparsdefectdirectrepairwithamodifiedsmileyfacerodforspondylolysisandisthmicspondylolisthesis AT hisarnorigamada noveltechniqueforparsdefectdirectrepairwithamodifiedsmileyfacerodforspondylolysisandisthmicspondylolisthesis AT reoasai noveltechniqueforparsdefectdirectrepairwithamodifiedsmileyfacerodforspondylolysisandisthmicspondylolisthesis AT fumihikoeto noveltechniqueforparsdefectdirectrepairwithamodifiedsmileyfacerodforspondylolysisandisthmicspondylolisthesis AT katsuyanagashima noveltechniqueforparsdefectdirectrepairwithamodifiedsmileyfacerodforspondylolysisandisthmicspondylolisthesis AT yosuketakeuchi noveltechniqueforparsdefectdirectrepairwithamodifiedsmileyfacerodforspondylolysisandisthmicspondylolisthesis AT torufunayama noveltechniqueforparsdefectdirectrepairwithamodifiedsmileyfacerodforspondylolysisandisthmicspondylolisthesis AT masashiyamazaki noveltechniqueforparsdefectdirectrepairwithamodifiedsmileyfacerodforspondylolysisandisthmicspondylolisthesis |