title: [Direct repair of adolescent lumbar spondylolysis using a pedicle screw-laminar hook system by paramedian approach].
abstract: OBJECTIVE
  To discuss the indication and clinical effect of direct repair of adolescent lumbar spondylolysis by screw-laminar hook system.
  
  
  METHODS
  From August 2003 to December 2008, 28 patients (13 males and 15 females,ranging in age from 15 and 26 years, averaged 21.6 years) with lumbar spondylolysis were treated with isthmic bone grafting and internal fixation with a pedicle screw-laminar hook system. Three patients had spondylolysis at L3, L4; 5 patients had spondylolysis at L4, L5; 8 patients had spondylolysis at L4; and 12 patients had spondylolysis at L5. All the patients had low back pain and lasted over 6 months. According to preoperative and postoperative plain radiograph, CT scan and Macnab criteria, the fusion rate and clinical effect of this technique were evaluated.
  
  
  RESULTS
  All the patients were followed up with a mean period of 14.9 months, ranging from 9 to 24 months. All the patients had bony union according to the X-rays and CT scan. According to the calculation results of Macnab criteria, 22 patients got an excellent result, 5 good and 1 fair.
  
  
  CONCLUSIONS
  The direct repair of adolescent lumbar spondylolysis with pedicle screw-laminar hook system can shorten length of operation,decrease blood loss, preserve more posterior structures of spine and avoid iatrogenic instability of spine. The postoperative immediate stability of vertebral segment is acquired and the mobility of adjacent intervertebral discs is reserved. The screw-laminar hook system for the treatment of adolescent spondylolisthesis can get satisfactory clinical results.
authors.affiliation: People's Armed Police Corps Hospital, Jiaxing 314000, Zhejiang, China. monarchy@sina.com
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
authors.forename: Yong-hua
authors.initials: YH
authors.lastname: Tang
authors.forename: Hong-chao
authors.initials: HC
authors.lastname: Tang
authors.forename: Cai-yi
authors.initials: CY
authors.lastname: Jin
mesh_terms: D000293:Adolescent; D000328:Adult; D001863:Bone Screws; D016025:Bone Transplantation; D005260:Female; D006801:Humans; D016268:Internal Fixators; D008159:Lumbar Vertebrae / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D013169:Spondylolysis / Q000503:physiopathology / Q000601:surgery*