EFFECTIVENESS OF U-SHAPE TITANIUM SCREW-ROD FIXATION SYSTEM WITH BONE AUTOGRAFTING FOR LUMBAR SPONDYLOLYSIS OF YOUNG ADULTS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 PUXiaobing , YANGShuangshi , CAOHaiquan , JINGXingquan , YINJun

Department of Spinal Surgery, the 188th Hospital of Chinese PLA, Chaozhou Guangdong, 521000, P. R. China;

Corresponding author：

PUXiaobing, Email: metalli@126.com

Keywords：

Lumbar spondylolysis; U-shape titanium screw-rod fixation system; Bone autografting; Young adult

DOI：

10.7507/1002-1892.20140079

Video：

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Objective To investigate the effectiveness of U-shape titanium screw-rod fixation system with bone autografting for lumbar spondylolysis of young adults. Methods Between January 2008 and December 2011, 32 patients with lumbar spondylolysis underwent U-shape titanium screw-rod fixation system with bone autografting. All patients were male with an average age of 22 years (range, 19-32 years). The disease duration ranged from 3 to 24 months (mean, 14 months). L₃ was involved in spondylolysis in 2 cases, L₄ in 10 cases, and L₅ in 20 cases. The preoperative visual analogue scale (VAS) and Oswestry disability index (ODI) scores were 8.0±1.1 and 75.3±11.2, respectively. Results The operation time was 80-120 minutes (mean, 85 minutes), and the blood loss was 150-250 mL (mean, 210 mL). Primary healing of incision was obtained in all patients without complications of infection and nerve symptom. Thirty-two patients were followed up 12-24 months (mean, 14 months). Low back pain was significantly alleviated after operation. The VAS and ODI scores at 3 months after operation were 1.0±0.5 and 17.6±3.4, respectively, showing significant differences when compared with preoperative ones (t=30.523,P=0.000;t=45.312,P=0.000). X-ray films and CT showed bone fusion in the area of isthmus defects, with the bone fusion time of 6-12 months (mean, 9 months). During follow-up, no secondary lumbar spondyloly, adjacent segment degeneration, or loosening or breaking of internal fixator was found. Conclusion The U-shape titanium screw-rod fixation system with bone autografting is a reliable treatment for lumbar spondylolysis of young adults because of a high fusion rate, minimal invasive, and maximum retention of lumbar range of motion.

Citation： PUXiaobing, YANGShuangshi, CAOHaiquan, JINGXingquan, YINJun. EFFECTIVENESS OF U-SHAPE TITANIUM SCREW-ROD FIXATION SYSTEM WITH BONE AUTOGRAFTING FOR LUMBAR SPONDYLOLYSIS OF YOUNG ADULTS. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(3): 354-357. doi: 10.7507/1002-1892.20140079 Copy

1.	Leone A, Cianfoni A, Cerase A, et al. Lumbar spondylolysis:a review. Skeletal Radiol, 2011, 40(6):683-700.
2.	Engelhardt M, Reuter I, Freiwald J, et al. Spondylolysis and spondylolisthesis and sports. Orthopade, 1997, 26(9):755-759.
3.	Wiltse LL, Widell EH Jr, Jackson DW. Fatigue fracture:the basic lesion is inthmic spondylolisthesis. J Bone Joint Surg (Am), 1975, 57(1):17-22.
4.	Turner RH, Bianco AJ Jr. Spondylolysis and spondylolisthesis in children and teenagers. J Bone Joint Surg (Am), 1971, 53(7):1298-1306.
5.	Steiner ME, Micheli LJ. Treatment of symptomatic spondylolysis and spondylolisthesis with the modified Boston brace. Spine (Phila Pa 1976), 1985, 10(10):937-943.
6.	Klein G, Mehlman CT, McCarty M. Nonoperative treatment of spondylolysis and grade I spondylolisthesis in children and young adults:a meta-analysis of observational studies. J Pediatr Orthop, 2009, 29(2):146-156.
7.	Kimura M. My method of filing the lesion with spongy bone in spondylolysis and spondylolistesis. Seikei Geka, 1968, 19(4):285-296.
8.	Buck JE. Direct repair of the defect in spondylolisthesis. Preliminary report. J Bone Joint Surg (Br), 1970, 52(3):432-437.
9.	Kim YT, Lee H, Lee CS, et al. Direct repair of the pars interarticularis defect in dpondylolysis. J Spinal Disord Tech, 2012.[Epub ahead of print].
10.	Hefti F, Seelig W, Morscher E. Repair of lumbar spondylolysis with a hook-screw. Int Orthop, 1992, 16(1):81-85.
11.	Morscher E, Gerber B, Fasel J. Surgical treatment of spondylolisthesis by bone grafting and direct stabilization of spondylolysis by means of a hook screw. Arch Orthop Trauma Surg, 1984, 103(3):175-178.
12.	Ivanic GM, Pink TP, Achatz W, et al. Direct stabilization of lumbar spondylolysis with a hook screw:mean 11-year follow-up period for 113 patients. Spine (Phila Pa 1976), 2003, 28(3):255-259.
13.	Roca J, Iborra M, Cavanilles-Walker JM, et al. Direct repair of spondylolysis using a new pedicle screw hook fixation:clinical and CT-assessed study:an analysis of 19 patients. J Spinal Disord Tech, 2005, 18 Suppl:S82-89.
14.	Nicol RO, Scott JH. Lytic spondylolysis. Repair by wiring. Spine (Phila Pa 1976), 1986, 11(10):1027-1030.
15.	Mohi Eldin M. Minimal access direct spondylolysis repair using a pedicle screw-rod system:a case series. J Med Case Rep, 2012, 6(1):396.
16.	Sairyo K, Sakai T, Yasui N. Minimally invasive technique for direct repair of pars interarticularis defects in adults using a percutaneous pedicle screw and hook-rod system. J Neurosurg Spine, 2009, 10(5):492-495.
17.	Widi GA, Williams SK, Levi AD. Minimally invasive direct repair of bilateral lumbar spine pars defects in athletes. Case Rep Med, 2013, 2013:659078.
18.	Louis R. Pars interarticularis reconstruction of spondylolysis using plates and screws with grafting without arthrodesis. Apropos of 78 cases. Rev Chir Orthop Reparatrice Appar Mot, 1988, 74(6):549-557.
19.	Gillet P, Petit M. Direct repair of spondylolysis without spondylolisthesis, using a rod-screw construct and bone grafting of the pars defect. Spine (Phila Pa 1976), 1999, 24(12):1252-1256.
20.	Altaf F, Osei NA, Garrido E, et al. Repair of spondylolysis using compression with a modular link and screws. J Bone Joint Surg (Br), 2011, 93(1):73-77.

1. Leone A, Cianfoni A, Cerase A, et al. Lumbar spondylolysis:a review. Skeletal Radiol, 2011, 40(6):683-700.
2. Engelhardt M, Reuter I, Freiwald J, et al. Spondylolysis and spondylolisthesis and sports. Orthopade, 1997, 26(9):755-759.
3. Wiltse LL, Widell EH Jr, Jackson DW. Fatigue fracture:the basic lesion is inthmic spondylolisthesis. J Bone Joint Surg (Am), 1975, 57(1):17-22.
4. Turner RH, Bianco AJ Jr. Spondylolysis and spondylolisthesis in children and teenagers. J Bone Joint Surg (Am), 1971, 53(7):1298-1306.
5. Steiner ME, Micheli LJ. Treatment of symptomatic spondylolysis and spondylolisthesis with the modified Boston brace. Spine (Phila Pa 1976), 1985, 10(10):937-943.
6. Klein G, Mehlman CT, McCarty M. Nonoperative treatment of spondylolysis and grade I spondylolisthesis in children and young adults:a meta-analysis of observational studies. J Pediatr Orthop, 2009, 29(2):146-156.
7. Kimura M. My method of filing the lesion with spongy bone in spondylolysis and spondylolistesis. Seikei Geka, 1968, 19(4):285-296.
8. Buck JE. Direct repair of the defect in spondylolisthesis. Preliminary report. J Bone Joint Surg (Br), 1970, 52(3):432-437.
9. Kim YT, Lee H, Lee CS, et al. Direct repair of the pars interarticularis defect in dpondylolysis. J Spinal Disord Tech, 2012.[Epub ahead of print].
10. Hefti F, Seelig W, Morscher E. Repair of lumbar spondylolysis with a hook-screw. Int Orthop, 1992, 16(1):81-85.
11. Morscher E, Gerber B, Fasel J. Surgical treatment of spondylolisthesis by bone grafting and direct stabilization of spondylolysis by means of a hook screw. Arch Orthop Trauma Surg, 1984, 103(3):175-178.
12. Ivanic GM, Pink TP, Achatz W, et al. Direct stabilization of lumbar spondylolysis with a hook screw:mean 11-year follow-up period for 113 patients. Spine (Phila Pa 1976), 2003, 28(3):255-259.
13. Roca J, Iborra M, Cavanilles-Walker JM, et al. Direct repair of spondylolysis using a new pedicle screw hook fixation:clinical and CT-assessed study:an analysis of 19 patients. J Spinal Disord Tech, 2005, 18 Suppl:S82-89.
14. Nicol RO, Scott JH. Lytic spondylolysis. Repair by wiring. Spine (Phila Pa 1976), 1986, 11(10):1027-1030.
15. Mohi Eldin M. Minimal access direct spondylolysis repair using a pedicle screw-rod system:a case series. J Med Case Rep, 2012, 6(1):396.
16. Sairyo K, Sakai T, Yasui N. Minimally invasive technique for direct repair of pars interarticularis defects in adults using a percutaneous pedicle screw and hook-rod system. J Neurosurg Spine, 2009, 10(5):492-495.
17. Widi GA, Williams SK, Levi AD. Minimally invasive direct repair of bilateral lumbar spine pars defects in athletes. Case Rep Med, 2013, 2013:659078.
18. Louis R. Pars interarticularis reconstruction of spondylolysis using plates and screws with grafting without arthrodesis. Apropos of 78 cases. Rev Chir Orthop Reparatrice Appar Mot, 1988, 74(6):549-557.
19. Gillet P, Petit M. Direct repair of spondylolysis without spondylolisthesis, using a rod-screw construct and bone grafting of the pars defect. Spine (Phila Pa 1976), 1999, 24(12):1252-1256.
20. Altaf F, Osei NA, Garrido E, et al. Repair of spondylolysis using compression with a modular link and screws. J Bone Joint Surg (Br), 2011, 93(1):73-77.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF U-SHAPE TITANIUM SCREW-ROD FIXATION SYSTEM WITH BONE AUTOGRAFTING FOR LUMBAR SPONDYLOLYSIS OF YOUNG ADULTS

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