Long-Dated Effect Of Direct Repair Of The Pars Interarticularis For Spondylolysis

OBJECTIVE: There are many therapeutic treatments to spondylolysis,but the choices are disputed.Multi-segmental fixation causes stress shielding and enhances adjacent segment'stress,so as to accelerate the degeneration of intervertebral disc.We reviewed 36 adult lumbar spondylolysis patients to approach the therapeutic efficacies of the direct fixation of the pars interarticularis using pedicle screw hook plate,according to the pathologic procedures a operation strategy and a clinical stage are made,which can be a reference to the operative treatments.METHODS:36 spondylolysis cases were cured with the pedicle screw hook plate we originally designed after normal nonoperative procedures.the follow up time is from 24 to 153 months with an average of 70.7months.berfore and afte r the operation,the radiographies were measured, including slipping percentage, disc index, fusion rate. The clinical efficanies were evaluated by JOA Scoring System. All the dataes are analyzed with SPSS software.RESULTS: The JOA scores were all improved significantly.The fusion rates were 100%. No pedicle screws were found broken down.Percentage of slipping and disc index preoperative and postoperative were no statistical differences.CONCLUSIONS: The good therapeutic efficacies are got with the direct fixation of the pars interarticularis and the one spinal function unit fixation. We consider that lumbar spondylolysis and spondylolisthesis is a pathologic procedure which is gradually developed. Under the condition that the spondylolysis can not be cured by nonoperative procedures,an operation should be taken in time.The direct fixation of the pars interarticularis and the one spinal function unit fixation are prefered to.The multi-segment spinal function unit fixation should be avoided.