title: [Effectiveness of posterior intrasegmental fixation with pedicle screw-lamina hook system in treatment of lumbar spondylolysis].
abstract: OBJECTIVE
  To investigate the effectiveness of posterior intrasegmental fixation with pedicle screw-lamina hook system and bone grafting for lumbar spondylolysis.
  
  
  METHODS
  Between January 2005 and October 2009, 22 patients with lumbar spondylolysis underwent posterior intrasegmental fixation with pedicle screw-lamina hook system and bone grafting. There were 19 males and 3 females with an average age of 18.4 years (range, 12-26 years). The main symptom was low back pain with an average disease duration of 16 months (range, 8-56 months). The visual analogue scale (VAS) was 6.0 +/- 1.2 and Oswestry disability index (ODI) was 72.0% +/- 10.0% preoperatively. The X-ray films showed bilateral spondylolysis at L4 in 9 cases and at L5 in 13 cases. The range of motion (ROM) at upper and lower intervertebral spaces was (11.8 +/- 2.8) degrees and (14.1 +/- 1.9) degrees, respectively.
  
  
  RESULTS
  All incisions healed by first intention. All patients were followed up 12-45 months (mean, 25 months). Low back pain was significantly alleviated after operation. The VAS score (0.3 +/- 0.5) and ODI (17.6% +/- 3.4%) were significantly decreased at last follow-up when compared with preoperative scores (P < 0.05). CT showed bone graft fusion in the area of isthmus defects, with no loosening or breaking of internal fixator. At last follow-up, the lateral flexion-extension X-ray films of the lumbar spine showed that the ROM at upper and lower intervertebral spaces was (12.3 +/- 2.1) degrees and (13.5 +/- 1.7) degrees, respectively; showing significant differences when compared with preoperative values (P < 0.05). Pain at donor site of iliac bone occurred in 1 case, and was cured after pain release treatment.
  
  
  CONCLUSIONS
  The posterior intrasegmental fixation with pedicle screw-lamina hook system and bone grafting is a reliable treatment for lumbar spondylolysis, having a high fusion rate, low complication rate, and maximum retention of lumbar ROM.
authors.affiliation: Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R. China.
authors.forename: Zhongjie
authors.initials: Z
authors.lastname: Zhou
authors.forename: Yueming
authors.initials: Y
authors.lastname: Song
authors.forename: Jiancheng
authors.initials: J
authors.lastname: Zeng
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
authors.forename: Limin
authors.initials: L
authors.lastname: Liu
authors.forename: Qingquan
authors.initials: Q
authors.lastname: Kong
authors.forename: Tao
authors.initials: T
authors.lastname: Li
authors.forename: Quan
authors.initials: Q
authors.lastname: Gong
mesh_terms: D000293:Adolescent; D000328:Adult; D001863:Bone Screws; D016025:Bone Transplantation / Q000379:methods; D002648:Child; D005260:Female; D006801:Humans; D016268:Internal Fixators; D017116:Low Back Pain / Q000209:etiology / Q000473:pathology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000295:instrumentation; D013123:Spinal Fusion / Q000295:instrumentation*; D013169:Spondylolysis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult