• Zhongjie Zhou, Yueming Song, Jiancheng Zeng, Hao Liu, Limin Liu, Qingquan Kong, Tao Li, and Quan Gong.
• Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R. China.
• Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2013 Mar 1; 27 (3): 274-7.

ObjectiveTo investigate the effectiveness of posterior intrasegmental fixation with pedicle screw-lamina hook system and bone grafting for lumbar spondylolysis.MethodsBetween 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.ResultsAll 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.ConclusionThe 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.

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