title: V-rod technique for direct repair surgery of pediatric lumbar spondylolysis combined with posterior apophyseal ring fracture.
abstract: We report a pediatric baseball player having both a fracture of the posterior ring apophysis and spondylolysis. He was presented to a primary care physician complaining of back pain and leg pain. Despite conservative treatment for 3 months, the pain did not subside. He was referred to our clinic, and surgical intervention was carried out. First, a bony fragment of the caudal L5 apophyseal ring was removed following fenestration at the L5-S interlaminal space, bilaterally: and decompression of the bilateral S1 nerve roots was confirmed. Next, pseudoarthrosis of the L5 pars was refreshed and pedicle screws were inserted bilaterally. A v-shaped rod was inserted beneath the L5 spinous process, which stabilized the pars defects. After the surgery, back pain and leg pain completely disappeared. In conclusion, the v-rod technique is appropriate for the spondylolysis direct repair surgery, especially, in case the loose lamina would have a partial laminotomy.
authors.affiliation: Department of Orthopedic Surgery, Teikyo University Mizonokuchi Hospital, Kawasaki, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Sumita
authors.forename: Koichi
authors.initials: K
authors.lastname: Sairyo
authors.forename: Isao
authors.initials: I
authors.lastname: Shibuya
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kitahama
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Kanamori
authors.forename: Hironori
authors.initials: H
authors.lastname: Matsumoto
authors.forename: Soichi
authors.initials: S
authors.lastname: Koga
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kitagawa
authors.forename: Akira
authors.initials: A
authors.lastname: Dezawa
keywords: Apophyseal ring fracture; Spondylolysis; V-rod technique