Direct screw repair of pars interarticularis offers satisfactory outcomes in adolescents

Snyder LA. J Neurosurg. 2014. doi:10.3171/2014.5.SPINE13772.

Direct screw repair of the pars interarticularis provides a minimally invasive option for the treatment of spondylolysis in adolescent athletes with satisfactory clinical and radiological outcomes, according to study findings.

Laura A. Snyder, MD, and colleagues identified 16 adolescents treated with direct screw placement through the fractured pars, also known as Buck’s procedure, between 2004 and 2010. The researchers retrospectively recorded and analyzed patient demographics and clinical and radiological outcomes.

All patients displayed axial back pain, and 38% had concomitant radiculopathy. The researchers identified bilateral pars defects in 81% and unilateral defects in 19% of the patients.

Postoperatively, 94% of patients were completely or partially free of symptoms. Healing was observed in 89.6% of the 29 total pars defects prior to a revision surgery. Additionally, the researchers observed an overall fusion rate of 97% at final radiological follow-up.

No implant failures were reported, and all eight athletes in the study group had returned to play at the final follow-up, according to the researchers.

Snyder and colleagues concluded that direct screw repair of the pars interarticularis defect may be a more minimally invasive procedure than the more commonly used pedicle screw-hook approach.

Disclosure: The authors have no relevant financial disclosures.



Josh Sandberg

Josh Sandberg is the President of Ortho Sales Partners and Partner for The De Angelis Group. He also serves as Co-Founder and Editor of OrthoSpineNews.

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