Mid-Term Results of Young Adult Patients Who Underwent Autograft and Direct Pars Repair Using U-Rod Technique for Lumbar Spondylolysis

Abstract

Objective: This study aimed to present the clinical and radiological results of patients with spondylolysis (SL) with pars interarticularis defect who were treated with a pedicle screw and a U-shaped rod system passed under the spinous process. Materials and Methods: A total of 26 patients with lumbar SL and pars fracture were included in the study. Their demographic characteristics were recorded. Patients with adjacent disc pathology and Grade 2, 3, 4 spondylolistheses were excluded. Clinical outcomes were evaluated with visual analog score (VAS) and Oswestry Disability Index (ODI) preoperatively and at the postoperative 3-year follow-up. Radiologically, union was evaluated with plain radiographs and computed tomography if necessary. Patients’ return to their daily routine and sports were also evaluated. Results: Of the 26 patients included in the study, 16 were male (57.1%) and 12 were female (42.8%). The mean age of the patients was 16.7±12.1 years (13-20). Patients were followed up for an average of 51.2 (36-78) months. The mean ODI score was 33.4±21.2 (24-46) and the mean VAS score was 8.1±1.2 (7-10) preoperatively, whereas the mean ODI score was 16.8±11.6 (10-21.4) and the mean VAS score was 1.4±2.3 (1-3) at the postoperative third year follow-up. Six patients who were professional athletes returned to their sports life at the eighth month. Patients’ pars fractures were united. One (3.5%) patient underwent revision surgery due to delayed union. Superficial tissue infection developed on the wound site in one patient and was treated with daily dressing and oral antibiotherapy. Conclusion: Good clinical and radiological results can be obtained in the young adult population with SL accompanied by pars fractures via polyaxial pedicle screws and U-shaped rod surgery.