"Temporary" Short Segment Fixation in Treating Adolescent Lumbar Spondylolysis

Area of Science:

• Orthopedic Surgery
• Spinal Surgery
• Adolescent Spine Conditions

Background:

• Isthmic spondylolysis is a common cause of chronic low back pain in adolescents.
• Traditional treatments may have limitations in addressing spinal stability and pain.
• A novel surgical approach was developed to treat this condition.

Purpose of the Study:

• To evaluate the clinical efficacy of a new surgical operation for adolescent isthmic spondylolysis.
• To assess the effectiveness of temporary short-segmental pedicle screw fixation with transverse device and bone grafting.
• To determine the impact of this temporary fixation on spinal fusion, pain, and adjacent segment health.

Main Methods:

• A cohort of 30 adolescent patients with isthmic spondylolysis underwent temporary short-segmental pedicle screw and transverse device fixation with isthmic bone grafting.
• Radiographic and CT imaging were used to assess bone graft fusion postoperatively.
• Lumbar MRI was performed pre- and post-surgery to evaluate vertebral endplate and intervertebral disc degeneration using Modic and Pfirrmann grading.

Main Results:

• All 30 patients completed the 2-year follow-up with complete resolution of low back pain.
• Radiographic and CT confirmed successful bony fusion of the isthmus in all cases.
• Internal fixation removal restored motion at the treated spinal segment, and no increased degeneration of the vertebral endplate or intervertebral disc was observed.

Conclusions:

• Temporary short-segmental pedicle screw combined with transverse device fixation is a simple and effective surgical method for adolescent isthmic spondylolysis.
• This technique promotes rigid internal fixation and accelerates bone graft fusion.
• The approach successfully alleviates pain and restores spinal segment mobility without causing adjacent segment degeneration.