Irrigation endoscopic assisted percutaneous pars repair: technical note. 2016

Hesham Magdi Soliman
Department of Orthopedic Surgery, Faculty of Medicine, Cairo University, 21A Abdelaziz Al Seoud, Manial-EL Roda, Cairo, Egypt. Electronic address: Heshamsol1@yahoo.com.

Spondylolysis is a common source of low back pain in children and adolescents. Despite the benign natural history of the pathology, however, it should be noted that as part of conservative management many young individuals are forced to discontinue their routine sports activities. In cases resistant to conservative management, direct repair of a pars defect is considered a safe and effective option in young adults with preserved discs. Recently, some reports of minimally invasive pars repair have been described, aiming at preservation of the paraspinal muscles and improvement of the postoperative course. The study aimed to present a new minimally invasive endoscopic technique for pars repair. This is a technical note. Seven consecutive patients complaining of back pain due to spondylolysis and resistant to conservative management were included. Outcome was assessed using the modified Macnab criteria, and bone union was assessed on postoperative radiographs. Two portals of 0.5 cm were used on each side, 1 cm lateral to the midline. One portal is used for the endoscope and the second for the surgical instruments. Following endoscopic debridement of the defect, the inferior portal was used for percutaneous placement of the Buck screw. There was no source for external funding for this study and no potential conflict of interest to disclose. Outcome was excellent in six cases and good in one case. All patients returned back to their normal level of activities. Complete radiographic union was seen in all patients. The mean period of postoperative hospital stay and follow-up was 8 hours and 21 months, respectively. The irrigation endoscopic technique has previously shown promising results in lumbar discectomy and laminectomy. Similar results were observed in the current study on the ability to achieve minimally invasive pars defect debridement and a smooth postoperative course. This is a pilot study and larger patient series and different surgeons' experience are required for further evaluation of the technique.

UI MeSH Term Description Entries
D007796 Laminectomy A surgical procedure that entails removing all (laminectomy) or part (laminotomy) of selected vertebral lamina to relieve pressure on the SPINAL CORD and/or SPINAL NERVE ROOTS. Vertebral lamina is the thin flattened posterior wall of vertebral arch that forms the vertebral foramen through which pass the spinal cord and nerve roots. Laminotomy,Laminectomies,Laminotomies
D008159 Lumbar Vertebrae VERTEBRAE in the region of the lower BACK below the THORACIC VERTEBRAE and above the SACRAL VERTEBRAE. Vertebrae, Lumbar
D008297 Male Males
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D001863 Bone Screws Specialized devices used in ORTHOPEDIC SURGERY to repair bone fractures. Bone Screw,Screw, Bone,Screws, Bone
D004724 Endoscopy Procedures of applying ENDOSCOPES for disease diagnosis and treatment. Endoscopy involves passing an optical instrument through a small incision in the skin i.e., percutaneous; or through a natural orifice and along natural body pathways such as the digestive tract; and/or through an incision in the wall of a tubular structure or organ, i.e. transluminal, to examine or perform surgery on the interior parts of the body. Endoscopic Surgical Procedures,Surgical Procedures, Endoscopic,Endoscopic Surgical Procedure,Endoscopy, Surgical,Surgical Endoscopy,Surgical Procedure, Endoscopic,Procedure, Endoscopic Surgical,Procedures, Endoscopic Surgical
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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