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Bilateral three-level lumbar spondylolysis repaired by hook-screw technique
Guive Sharifi1, Amin Jahanbakhshi1, Behnam Daneshpajouh1
1Department of Neurosurgery, Loghman Hakim Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Global Spine Journal
|December 20, 2013
Summary
This study presents a successful direct repair of multilevel lumbar spondylolysis using a novel hook-screw technique. The innovative surgical method effectively treated chronic low back pain and sciatica in a patient with bilateral spondylolysis.
Area of Science:
- Orthopedic Surgery
- Spine Surgery
- Biomedical Engineering
Background:
- Lumbar spondylolysis, a defect in the pars interarticularis, often causes chronic low back pain and sciatica.
- Multilevel and bilateral spondylolysis present unique surgical challenges.
- Conservative management is frequently insufficient for severe or multilevel cases.
Purpose of the Study:
- To report a case of bilateral three-level lumbar spondylolysis (L3, L4, L5).
- To describe the direct surgical repair using a hook-screw technique.
- To evaluate the efficacy of this technique for pain relief and spinal fusion.
Main Methods:
- Diagnosis confirmed via imaging studies and diagnostic anesthetic block.
- Surgical correction involved a direct repair technique using a hook-screw device.
- Decortication of the lysis area and iliac crest autograft were utilized.
- Postoperative assessment focused on pain recovery and fusion rates.
Main Results:
- The hook-screw technique successfully repaired bilateral three-level lumbar spondylolysis.
- The patient experienced significant pain recovery.
- Radiographic evidence confirmed successful fusion at the operated levels.
Conclusions:
- Direct surgical repair with the hook-screw technique is an effective treatment for symptomatic multilevel lumbar spondylolysis.
- This technique offers a viable option for patients with bilateral multilevel defects.
- The combination of hook-screw fixation, decortication, and autograft promotes favorable fusion and pain relief.
