Repair of the Pars Interarticularis Defect With a Cable-Screw Construct

Songer, Matthew N.; Rovin, Richard

doi:10.1097/00007632-199801150-00023

Cited by 67 publications

(62 citation statements)

References 16 publications

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“…Excellent results have been reported with the use of this method. The technique has originally been reported by Songer et al [19]. In a series of 7 patients, union could be achieved in all their cases.…”

Section: Discussionmentioning

confidence: 99%

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The Use of Cable-Screw Construct as an Effective Method for Direct Pars Repair

Arafa¹,

Zahlawy²,

Abdelrady³

2018

MOJOR

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Background: The aim of this study is to assess the use of cable-wire construct together with bone grafting for direct repair of pars defects in spondylolysis. Patient and methods:Thirty patients with bilateral pars defect in complaining of low back pain were included in this prospective study. A cable-screw construct was used for pars repair after failure of conservative measures. Patients were assessed radiologically for union and clinically by Oswestry disability index (ODI) and VAS for back pain. Demographic data and any complications were noted. Results:The mean follow up period was 22 months. The mean preoperative ODI and VAS were 67.77 and 8.2 respectively. This improved to 11.07 and 1.33 at final follow up. The improvements were statistically significant. At the final follow up, radiological healing could be achieved bilaterally in all patients (86.6%) but four. Three of them had initial defects >3mm and 1 from 2-3mm. For the healed cases, the mean time to union was 4.7 months. Conclusion:The cable-screw construct appears to be a rigid, low profile construct with high success rates in treating pars defects both radiologically and clinically.Citation: Arafa AM, Zahlawy HE, Abdelrady AM (2017) The Use of Cable-Screw Construct as an Effective Method for Direct Pars Repair. MOJ Orthop Rheumatol 9(5): 00372.

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Section: Discussionmentioning

confidence: 99%

“…The constructs have to overcome the high stresses on the pars with extension and torsion. They should also not interfere with the surface area for bone grafting [14,19].…”

Section: Discussionmentioning

confidence: 99%

The Use of Cable-Screw Construct as an Effective Method for Direct Pars Repair

Arafa¹,

Zahlawy²,

Abdelrady³

2018

MOJOR

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“…This technique needs extensive exposure, and fixation is dependent on the transverse process, which is not very strong. This technique was further simplified by Salib [16] and Songer [18] using a pedicle screw and wire or cable system to achieve strong fixation. Van Dam [19] further modified Songer's technique by passing a cable around the spinous process instead of the sublaminar position.…”

Section: Discussionmentioning

confidence: 99%

“…Hefti [9] reported a successful outcome of 88% in patients less than 20 and 71% in patients over 20 years. The primary reason for failure of fixation in the older population is due to the presence of degenerative disc disease [18]. Buck [1] originally suggested that his technique was appropriate only in patients in whom there was lysis of less than 3 mm.…”

Section: Discussionmentioning

confidence: 99%

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Repair of spondylolytic defect with a cable screw reconstruction

Pai

Hodgson

2007

International Orthopaedics (SICO

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We present the clinical and radiological results of surgical repair for refractory spondylolysis in 20 patients at a minimum follow-up of 2 years. Seventeen of them were reassessed after 5 years. The Oswestry scores revealed good to excellent results in 90% (18/20 patients), indicating a good outcome with surgical repair using two techniques: the Scott procedure or pedicle screw and wire technique. Radiological pseudarthosis was 10%, which was quite consistent with reported series. CT scanning of the 14 patients after a mean of 13 months revealed complete healing of the fracture in 7 patients, partial in 2 and frank non-union in 5. Overall, CT examination with reversed gantry showed only 7/14 (50%) healing, indicating that radiological healing on plain X-ray is not always suggestive of complete bony healing. However, CT healing is not a sine qua non of good to excellent clinical outcome.Résumé Nous présentons les résultats cliniques et radiologiques des 20 patients présentant une récidive de spondylolyse avec un minimum de recul de 5 ans (7.5 ans). Le score d'Oswestry a montré un bon et un excellent résultat chez 90% des patients (18/20) en utilisant deux techniques, la technique de Scott ou la technique des vis pédiculaires avec fil métallique. La pseudarthrose radiologique est de 10%. Un scanner réalisé chez 14 patients avec un recul de 13 mois a montré une guérison complète de la fracture chez 7 patients, partielle chez 2 et une pseudarthrose dans 5 cas. L'examen au scanner a mis en évidence que le taux de guérison radiologique n'était que de 50%, néanmoins cette consolidation scannographique n'est pas nécessaire pour avoir un bon résultat final sur le plan clinique.

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