Abstract
We present the clinical and radiological results of surgical repair for refractory spondylolysis in 20 patients at a minimum follow-up of 2 years. Seventeen of them were reassessed after 5 years. The Oswestry scores revealed good to excellent results in 90% (18/20 patients), indicating a good outcome with surgical repair using two techniques: the Scott procedure or pedicle screw and wire technique. Radiological pseudarthosis was 10%, which was quite consistent with reported series. CT scanning of the 14 patients after a mean of 13 months revealed complete healing of the fracture in 7 patients, partial in 2 and frank non-union in 5. Overall, CT examination with reversed gantry showed only 7/14 (50%) healing, indicating that radiological healing on plain X-ray is not always suggestive of complete bony healing. However, CT healing is not a sine qua non of good to excellent clinical outcome.
Résumé
Nous présentons les résultats cliniques et radiologiques des 20 patients présentant une récidive de spondylolyse avec un minimum de recul de 5 ans (7.5 ans). Le score d’Oswestry a montré un bon et un excellent résultat chez 90% des patients (18/20) en utilisant deux techniques, la technique de Scott ou la technique des vis pédiculaires avec fil métallique. La pseudarthrose radiologique est de 10%. Un scanner réalisé chez 14 patients avec un recul de 13 mois a montré une guérison complète de la fracture chez 7 patients, partielle chez 2 et une pseudarthrose dans 5 cas. L’examen au scanner a mis en évidence que le taux de guérison radiologique n’était que de 50%, néanmoins cette consolidation scannographique n’est pas nécessaire pour avoir un bon résultat final sur le plan clinique.
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Pai, V.S., Hodgson, B. & Pai, V. Repair of spondylolytic defect with a cable screw reconstruction. International Orthopaedics (SICO 32, 121–125 (2008). https://doi.org/10.1007/s00264-006-0277-6
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DOI: https://doi.org/10.1007/s00264-006-0277-6