Direct Repair of Symptomatic Lumbar Spondylolysis Using Rod-Screw-Cable System

Area of Science:

• Spine surgery
• Orthopedic surgery
• Surgical techniques

Background:

• Lumbar spondylolysis is a common spinal condition causing low back pain.
• Current treatments for symptomatic spondylolysis may involve conservative management or surgical intervention.
• Direct lysis repair offers a potential alternative for stabilizing the affected spinal segment.

Purpose of the Study:

• To evaluate the efficacy of a novel direct lysis repair technique for symptomatic lumbar spondylolysis.
• To assess the clinical outcomes of using a rod, screws, and Songer cable system for internal fixation.
• To determine the safety and effectiveness of this surgical approach in a patient cohort.

Main Methods:

• A prospective study included 16 patients with symptomatic lumbar spondylolysis treated between December 2015 and January 2020.
• The surgical technique involved Magerl pedicle screwing, direct lysis repair with bone allograft and demineralized bone matrix, and stabilization with a rod-screw-cable system.
• Clinical outcomes were assessed using the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) at multiple postoperative time points.

Main Results:

• Sixteen patients (11 male, 5 female; mean age 47 years) with L4 or L5 spondylolysis were analyzed.
• Significant improvements were observed in VAS scores (from 7.3 preoperatively to 1.9 at 2 years) and ODI (from 59.8% to 16.9%).
• No cases of increased slip or significant complications like implant failure were reported during a mean follow-up of 41 months.

Conclusions:

• The direct lysis repair technique with internal fixation provides rigid, intra-segmental stabilization for lumbar spondylolysis.
• This method effectively reduces pain and improves function in patients with spondylolysis.
• The technique is suitable even for older patients or those with coexisting disc degeneration, offering a reliable surgical option.