title: Posterior Dynamic Stabilization With Direct Pars Repair via Wiltse Approach for the Treatment of Lumbar Spondylolysis: The Application of a Novel Surgery.
abstract: METHODS
  A retrospective study to evaluate the clinical outcomes of a novel surgical method for treating patients with lumbar spondylolysis.
  
  
  OBJECTIVE
  The aim of this study was to investigate the effectiveness of posterior ISOBAR TTL stabilization of the lumbar spine with direct pars repair using Wiltse approach for the treatment of lumbar spondylolysis with or without slight spondylolisthesis and discuss the indications of this surgery.
  
  
  BACKGROUND
  Surgical treatment of lumbar spondylolysis has yielded relatively good results. However, there are still many limitations of the current surgical methods, including, adjacent level degeneration, restricted indications, and soft tissue damage.
  
  
  METHODS
  Between August 2010 and January 2013, 13 (9 males and 4 females; mean age: 28.2 yrs), patients with lumbar spondylolysis with or without slight spondylolisthesis underwent posterior ISOBAR TTL stabilization of the lumbar spine, with direct pars repair via Wiltse approach. All patients were followed up for at least 24 months at outpatient visits or telephonically. Pre-operative and postoperative radiological assessments included anteroposterior, lateral and flexion extension radiographs, 3-dimensional reconstruction computed tomography (CT), and magnetic resonance imaging (MRI). Data pertaining to intraoperative blood loss, duration of operation, visual analog score (VAS), Oswestry disability index (ODI) scores, and other assessments were collected.
  
  
  RESULTS
  The median follow-up duration was 36 months (range, 24-53 months). Surgery was successful in all patients with no complications; bony fusion of pars was confirmed on CT scan at postoperative 2 years. Significant pain relief was achieved in all patients including those with discogenic pain, those >30 years of age, and those with severe disc degeneration (P < 0.01).
  
  
  CONCLUSIONS
  We evaluated a new surgical technique for the treatment of patients with spondylolysis with or without slight spondylolisthesis. Besides the good clinical results, the indications for this new surgery are much wider and can potentially overcome the limitations of earlier techniques.
  
  
  METHODS
  4.
authors.affiliation: *Department of Orthopaedic Surgery, West China Hospital of Sichuan University, Chengdu, China †Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China ‡Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China §Department of Orthopaedic Surgery, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts.
authors.forename: Rong
authors.initials: R
authors.lastname: Xing
authors.forename: Qingyu
authors.initials: Q
authors.lastname: Dou
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Li
authors.forename: Yin
authors.initials: Y
authors.lastname: Liu
authors.forename: Qingquan
authors.initials: Q
authors.lastname: Kong
authors.forename: Qi
authors.initials: Q
authors.lastname: Chen
authors.forename: Quan
authors.initials: Q
authors.lastname: Gong
authors.forename: Jiancheng
authors.initials: J
authors.lastname: Zeng
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
authors.forename: Yueming
authors.initials: Y
authors.lastname: Song
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data*; D013169:Spondylolysis / Q000601:surgery*; D055815:Young Adult