Percutaneous Spondylolysis Repair Using Headless Compression Screws with a Cortical Bone Trajectory: A Technical Description and Case Series.

Abstract

Introduction: Lumbar spondylolysis (LS) is a stress fracture of the pars interarticularis that can occur in adolescents. Both early- and progressive-stage LS can be successfully treated with conservative therapy consisting of activity modification and external bracing; however, conservative therapy is not suitable for athletes who hope for an early return to sports. We introduce a novel, minimally invasive surgical technique for the treatment of LS that enables an early return to sports and describe surgical results, including bone union rates, time of both bone unions, and return to sports.

Technical note: To facilitate an early return to sports in adolescent athletes with early-to-progressive-stage LS, we developed a percutaneous spondylolysis repair technique using cannulated compression headless screws with a cortical bone trajectory. Fourteen adolescent athletes underwent this technique; as a result, all athletes achieved bone union and returned to sports within 3 months.

Conclusions: This minimally invasive surgical technique for LS can achieve early bone union in adolescent athletes, thereby facilitating an early return to sports.