Skip to main content
Log in

Percutaneous pars interarticularis screw fixation: a technical note

  • Ideas and Technical Innovations
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Purpose

A conventional midline posterior approach is used for most of the described surgical techniques. We describe a technique of percutaneous fixation of the pars interarticularis, augmented where necessary by grafting the defect, which minimises muscle injury.

Method

A 4.5 mm partially threaded dynamic compression screw is placed over a wire inserted percutaneously across the pars interarticularis defect. Compression is achieved across the pars interarticularis defect on placement of the screw. The screw is locked in a compressed state.

Results

The patient is mobilised the same day with a corset for comfort and discharged the following day. Aerobic fitness is maintained for 3 months; then, focused rehabilitation performed until a CT scan confirms healing at 5–6 months, at which stage full (sports) activity is resumed.

Conclusions

The minimal tissue injury and small incision used allow for the minimising of complications and for a rapid recovery and discharge from hospital. With adolescents, we have the opportunity to treat symptomatic pars interarticularis defects with minimal disruption to their academic and physical development.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Fredrickson BE, Baker D, McHolick WJ et al (1984) The natural history of spondylolysis and spondylolisthesis. J Bone Joint Surg Am 66:699–707

    CAS  PubMed  Google Scholar 

  2. Debnath UK, Freeman BJC, Gregory P et al (2003) Clinical outcome and return to sport after surgical treatment of spondylolysis in young athletes. J Bone Joint Surg Br 85:244–249

    Article  CAS  PubMed  Google Scholar 

  3. Rossi F, Dragoni S (1990) Lumbar spondylolysis: occurrence in competitive athletes. Updated achievements in a series of 390 cases. J Sports Med Phys Fitness 30:450–452

    CAS  PubMed  Google Scholar 

  4. Bonnici AV, Koka SR, Richards DJ (1991) Results of Buck screw fusion in grade I spondylolisthesis. J R Soc Med 84:270–273

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Buck JE (1970) Direct repair of the defect in spondylolisthesis. Preliminary report. J Bone Joint Surg Br 52:432–437

    CAS  PubMed  Google Scholar 

  6. Buck JE (1970) Further thoughts on direct repair of the defect in spondylolysis. J Bone Joint Surg Br 61:123

    Google Scholar 

  7. Nicol RO, Scott JH (1986) Lytic spondylolysis. Repair by wiring. Spine 11:1027–1030

    Article  CAS  PubMed  Google Scholar 

  8. Kakiuchi M (1997) Repair of the defect in spondylolysis: durable fixation with pedicle screws and laminar hooks. J Bone Joint Surg Am 79:818–825

    CAS  PubMed  Google Scholar 

  9. Tokuhashi Y, Matsuzaki H (1996) Repair of defects in spondylolysis by segmental pedicular screw hook fixation. A preliminary report. Spine 21:2041–2045

    Article  CAS  PubMed  Google Scholar 

  10. Kawaguchi Y, Matsui H, Tsuji H (1994) Back muscle injury after posterior lumbar spine surgery: part 1. Histologic and histochemical analyses in rats. Spine 19:2590–2597

    Article  CAS  PubMed  Google Scholar 

  11. Kawaguchi Y, Matsui H, Tsuji H (1994) Back muscle injury after posterior lumbar spine surgery: part 2. Histologic ad histochemical analyses in humans. Spine 19:2598–2602

    Article  CAS  PubMed  Google Scholar 

  12. Styf JR, Willen J (1998) The effects of external compression by three different retractors on pressure in the erector spine muscles during and after posterior lumbar spine surgery in humans. Spine 23:354–358

    Article  CAS  PubMed  Google Scholar 

  13. Sihvonen T, Herno A, Paljarvi L et al (1993) Local denervation atrophy of paraspinal muscles in postoperative failed back syndrome. Spine 18:575–581

    Article  CAS  PubMed  Google Scholar 

  14. Fan S, Hu Z, Zhao F et al (2010) Multifidus muscle changes and clinical effects of one-level posterior lumbar interbody fusion: minimally invasive procedure versus conventional open approach. Eur Spine J 19(2):316–324

    Article  PubMed  PubMed Central  Google Scholar 

  15. Stevens KJ, Spenciner DB, Griffiths KL et al (2006) Comparison of minimally invasive and conventional open posterolateral lumbar fusion using magnetic resonance imaging and retraction pressure studies. J Spinal Disord Tech 19:77–86

    Article  PubMed  Google Scholar 

  16. Tsutsumimoto T, Shimogata M, Ohta H, Misawa H (2009) Mini-open versus conventional open posterior lumbar interbody fusion for the treatment of lumbar degenerative spondylolisthesis: comparison of paraspinal muscle damage and slip reduction. Spine 34:1923–1928

    Article  PubMed  Google Scholar 

  17. Kim KT, Lee SH, Suk KS, Bae SC (2006) The quantitative analysis of tissue injury markers after mini-open lumbar fusion. Spine 31:712–716

    Article  PubMed  Google Scholar 

  18. Menga EN, Kebaish KM, Jain A et al (2013) Clinical results and functional outcomes after direct intralaminar screw repair of spondylolysis. Spine 39(1):104–110

    Article  Google Scholar 

  19. Higashino K, Sairyo K, Katoh S et al (2007) Minimally invasive technique for direct repair of the pars defects in young adults using a spinal endoscope: a technical note. Minim Invasive Neurosurg 50(3):186–190

    Article  Google Scholar 

  20. Brennan RP, Smucker PY, Horn EM (2008) Minimally invasive image-guided direct repair of bilateral L-5 pars interarticularis defects. Neurosurg Focus 25(2):E13

    Article  PubMed  Google Scholar 

  21. Widi GA, Williams SK, Levi AD (2013) Minimally invasive direct repair of bilateral lumbar spine pars defects in athletes. Case Rep Med. doi:10.1155/2013/659078

  22. Kip PC, Esses SI, Doherty BI, Alexander JW, Crawford MJ (1994) Biomechanical testing of pars defect repairs. Spine 19:2692–2697

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Farhaan Altaf.

Ethics declarations

Conflict of interest

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wilson, L., Altaf, F. & Tyler, P. Percutaneous pars interarticularis screw fixation: a technical note. Eur Spine J 25, 1651–1654 (2016). https://doi.org/10.1007/s00586-015-4152-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-015-4152-2

Keywords

Navigation