Consecutive double-level lumbar spondylolysis successfully treated with the double "smiley face" rod method

Area of Science:

• Orthopedic Surgery
• Spinal Surgery
• Radiology

Background:

• Lumbar spondylolysis, characterized by bilateral pars defects, often causes chronic low back pain.
• Surgical intervention is considered for persistent symptoms unresponsive to conservative management.
• Direct repair techniques aim to restore spinal stability and alleviate pain.

Observation:

• A 29-year-old male presented with a 6-year history of chronic low back pain.
• Imaging revealed bilateral pars defects at L4 and L5 (lumbar vertebrae 4 and 5) without instability or scoliosis.
• The patient was referred for surgical treatment due to intractable pain.

Findings:

• The patient underwent direct pars defect repair using the double "smiley face" rod technique at L4 and L5.
• No intraoperative or postoperative complications were noted.
• One year post-surgery, the patient experienced complete resolution of low back pain (Visual Analog Scale score of 0) and returned to recreational tennis.

Implications:

• The double "smiley face" rod method is a viable and effective technique for treating consecutive double-level lumbar spondylolysis.
• This case report highlights a successful application of a less common surgical approach for pars defects.
• Further research may explore the long-term efficacy and broader applicability of this method in spinal surgery.