Percutaneous pars interarticularis screw fixation: a technical note

Purpose A conventional midline posterior approach is used for most of the described surgical techniques. We describe a technique of percutaneous fixation of the pars interarticularis, augmented where necessary by grafting the defect, which minimises muscle injury. Method A 4.5 mm partially threaded...

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Bibliographic Details
Published in:European spine journal 2016-06, Vol.25 (6), p.1651-1654
Main Authors: Wilson, Lester, Altaf, Farhaan, Tyler, Philippa
Format: Article
Language:English
Subjects:
Adolescent
Bone Screws
Humans
Ideas and Technical Innovations
Medicine
Medicine & Public Health
Neurosurgery
Orthopedic Procedures - adverse effects
Orthopedic Procedures - instrumentation
Orthopedic Procedures - methods
Spine - surgery
Spondylolysis - surgery
Surgical Orthopedics
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Summary:Purpose A conventional midline posterior approach is used for most of the described surgical techniques. We describe a technique of percutaneous fixation of the pars interarticularis, augmented where necessary by grafting the defect, which minimises muscle injury. Method A 4.5 mm partially threaded dynamic compression screw is placed over a wire inserted percutaneously across the pars interarticularis defect. Compression is achieved across the pars interarticularis defect on placement of the screw. The screw is locked in a compressed state. Results The patient is mobilised the same day with a corset for comfort and discharged the following day. Aerobic fitness is maintained for 3 months; then, focused rehabilitation performed until a CT scan confirms healing at 5–6 months, at which stage full (sports) activity is resumed. Conclusions The minimal tissue injury and small incision used allow for the minimising of complications and for a rapid recovery and discharge from hospital. With adolescents, we have the opportunity to treat symptomatic pars interarticularis defects with minimal disruption to their academic and physical development.
ISSN:0940-6719
1432-0932
DOI:10.1007/s00586-015-4152-2