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Percutaneous pars interarticularis screw fixation: a technical note

Authors
  • Wilson, Lester1
  • Altaf, Farhaan1
  • Tyler, Philippa1
  • 1 Royal National Orthopaedic Hospital, Stanmore, London, UK , London (United Kingdom)
Type
Published Article
Journal
European Spine Journal
Publisher
Springer-Verlag
Publication Date
Jul 26, 2015
Volume
25
Issue
6
Pages
1651–1654
Identifiers
DOI: 10.1007/s00586-015-4152-2
Source
Springer Nature
Keywords
License
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Abstract

PurposeA conventional midline posterior approach is used for most of the described surgical techniques. We describe a technique of percutaneous fixation of the pars interarticularis, augmented where necessary by grafting the defect, which minimises muscle injury.MethodA 4.5 mm partially threaded dynamic compression screw is placed over a wire inserted percutaneously across the pars interarticularis defect. Compression is achieved across the pars interarticularis defect on placement of the screw. The screw is locked in a compressed state.ResultsThe patient is mobilised the same day with a corset for comfort and discharged the following day. Aerobic fitness is maintained for 3 months; then, focused rehabilitation performed until a CT scan confirms healing at 5–6 months, at which stage full (sports) activity is resumed.ConclusionsThe minimal tissue injury and small incision used allow for the minimising of complications and for a rapid recovery and discharge from hospital. With adolescents, we have the opportunity to treat symptomatic pars interarticularis defects with minimal disruption to their academic and physical development.

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