[Effectiveness of posterior intrasegmental fixation with pedicle screw-lamina hook system in treatment of lumbar spondylolysis].

Abstract

OBJECTIVE:

To investigate the effectiveness of posterior intrasegmental fixation with pedicle screw-lamina hook system and bone grafting for lumbar spondylolysis.

METHODS:

Between January 2005 and October 2009, 22 patients with lumbar spondylolysis underwent posterior intrasegmental fixation with pedicle screw-lamina hook system and bone grafting. There were 19 males and 3 females with an average age of 18.4 years (range, 12-26 years). The main symptom was low back pain with an average disease duration of 16 months (range, 8-56 months). The visual analogue scale (VAS) was 6.0 +/- 1.2 and Oswestry disability index (ODI) was 72.0% +/- 10.0% preoperatively. The X-ray films showed bilateral spondylolysis at L4 in 9 cases and at L5 in 13 cases. The range of motion (ROM) at upper and lower intervertebral spaces was (11.8 +/- 2.8) degrees and (14.1 +/- 1.9) degrees, respectively.

RESULTS:

All incisions healed by first intention. All patients were followed up 12-45 months (mean, 25 months). Low back pain was significantly alleviated after operation. The VAS score (0.3 +/- 0.5) and ODI (17.6% +/- 3.4%) were significantly decreased at last follow-up when compared with preoperative scores (P < 0.05). CT showed bone graft fusion in the area of isthmus defects, with no loosening or breaking of internal fixator. At last follow-up, the lateral flexion-extension X-ray films of the lumbar spine showed that the ROM at upper and lower intervertebral spaces was (12.3 +/- 2.1) degrees and (13.5 +/- 1.7) degrees, respectively; showing significant differences when compared with preoperative values (P < 0.05). Pain at donor site of iliac bone occurred in 1 case, and was cured after pain release treatment.

CONCLUSION:

The posterior intrasegmental fixation with pedicle screw-lamina hook system and bone grafting is a reliable treatment for lumbar spondylolysis, having a high fusion rate, low complication rate, and maximum retention of lumbar ROM.

• Authors: Zhongjie Zhou, Yueming Song, Jiancheng Zeng, Hao Liu, Limin Liu, Qingquan Kong, Tao Li, Quan Gong
• Journal: Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery (Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi) Vol. 27 Issue 3 Pg. 274-7 (Mar 2013) ISSN: 1002-1892 [Print] China
• PMID: 23672123 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Bone Screws
• Bone Transplantation (methods)
• Child
• Female
• Humans
• Internal Fixators
• Low Back Pain (etiology, pathology, surgery)
• Lumbar Vertebrae (diagnostic imaging, pathology, surgery)
• Male
• Range of Motion, Articular
• Plastic Surgery Procedures (instrumentation)
• Spinal Fusion (instrumentation)
• Spondylolysis (diagnostic imaging, pathology, surgery)
• Tomography, X-Ray Computed
• Treatment Outcome
• Young Adult