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direct repair of the pars defect with ..

repair of the pars interarticularis defect can be an effective modality of treatment

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repair of the defect in spondylolisthesis.

Some of those have been technically difficult to perform or biomechanically inadequate to handle the forces across the pars interarticularis resulting in high failure rates [14]. In this study, we present a modified technique for direct pars repair using screws across the pedicles and sublaminar cables, together with the results of the procedure clinically and radiologically.

direct repair surgery is suitable in case without spondylolisthesis [8 ..

Definition: a spondylolisthesis occurs when the top vertebra of a motion segment (remember a motion segment is made up of two adjacent vertebrae and the disc in between them) slides (slips, or translates) forward in relationship to the bottom vertebra. Such movement is technically called sagittal anterior translation.

Direct repair of the defect in spondylolisthesis

and with slips of less than 10%, direct repair of the defect can be performed

Figure 1c: Pre-operative sagittal CT reconstruction showing an isthmic type defect with a low-grade spondylolidthesis that developed before skeletal maturity. This type of defect can still be repaired precutaneously, but it would need supplemental bone grafting of the defect to ensure bone healing.

Low-back pain is related to frequent or heavy lifting, carrying, pulling and pushing. High tensile forces are directed to the muscles and ligaments, and high compression to the bones and joint surfaces. These forces can cause mechanical injuries to the vertebral bodies, intervertebral discs, ligaments and the posterior parts of the vertebrae. The injuries may be caused by sudden overloads or fatigue due to repetitive loading. Repeated microtrauma, which may even occur without being noticed, have been proposed as a cause for degeneration of the lumbar spine.

“Direct repair of the defect in spondylolisthesis

Buck JE (1970) Direct repair of the defect in spondylolisthesis

Degenerative spondylolisthesis, which was first reported by German researchers back in the 1930s, [55] is a potentially painful condition of the spine that occurs when the degenerated facet joints of the affected vertebra fail to stop , which in turn results a spondylolisthesis (a slip). It is differentiated from isthmic spondylolisthesis by the absence of fracture in the pars interarticularis or the posterior arch.

One of the pitfalls, however, with direct repair is that historically there has been a high rate of failure to fuse (non-union or pseudoarthrosis). In fact in one investigation, the rate of pseudoarthrosis was an unacceptable 25%. [67]

Direct repair of defect in lumbar spondylolysis and mild isthmic spondylolisthesis by bone …
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  • Zhu HB (2001) Direct repair of defect in lumbar ..

    direct repair of the defect ..

  • Direct repair of the pars defect ..

    Buck JE: Direct repair of the defect in spondylolisthesis: preliminary report

  • spondylolisthesis were direct repair of pars .Direct Repair of ..

    direct repair of the pars defect without fusion may be appropriate

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Spondylolysis and Spondylolisthesis of the Lumbar …

A systematic review of the literature was performed to establish whether direct repair of the pars defect or intervertebral fusion achieves better Oswestry Disability Index scores in adolescent spondylolysis or low-grade spondylolisthesis. Nine studies fulfilled the inclusion criteria, reporting a minimum total of 80 direct repairs and 108 fusions because of presumed replication of data between studies. Little statistically or clinically significant difference could be established between the two interventions. The only comparative study showed improved long-term outcome with fusion. Further well-designed prospective comparative studies are required to establish the optimum treatment for this condition.

Spondylolisthesis Treatment, Surgery & Symptoms

With more advanced degeneration, dense disorganized fibrous tissue replaces the normalfibrocartilaginous structure of the nucleus pulposus, leaving no distinction between the nucleus andanulus fibrosus. Development of anular tears weakens the anulus and allows nucleus to protrude intothe defect. Tears that extend through the outer anulus induce ingrowth of granulation tissue andaccelerate the degenerative process. Advanced degeneration can lead to gas formation orcalcification within the disk. Also, fissures develop in the cartilaginous end plates, and regeneratingchondrocytes and granulation tissue form in the area.

There are five major types of lumbar spondylolisthesis

Bone in the skull and other selected sites forms directly by bone formation (intramembranous ossification) without passing through a cartilage intermediate phase. The long bones of the limbs develop from cartilage through a process known as endochondral ossification. This process is what leads to the normal growth of long bones, to the repair of fractures and, in late adult life, to the unique formation of new bone in a joint which has become osteoarthritic.

Adult Isthmic Spondylolisthesis - Spine - Orthobullets

A systematic review of the literature was performed to establish whether direct repair of the pars defect or intervertebral fusion achieves better Oswestry Disability Index scores in adolescent spondylolysis or low-grade spondylolisthesis. Nine studies fulfilled the inclusion criteria, reporting a minimum total of 80 direct repairs and 108 fusions because of presumed replication of data between studies. Little statistically or clinically significant difference could be established between the two interventions. The only comparative study showed improved long-term outcome with fusion. Further well-designed prospective comparative studies are required to establish the optimum treatment for this condition.

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