Direct Repair of the Defect in Spondylolysis

Kim, Yung Tae; Lee, Choon Sung; Noh, Kyung Min; Shon, Hyun Chul

Abstract

STUDY DESIGN: This is a retrospective study analysing the results of Buck's operation for spondylolysis. PURPOSE: To analyze the results of Buck`s methods as a treatment for symptomatic spondylolysis clinically and radiographically.
MATERIALS AND METHODS
Between March 1992 and March 1999, 12 patients with symptomatic spondylolysis were treated with Buck`s method. Surgical indication was 1)under 30 years of age, 2) patients with intractable low back pain without sciatica who did not response to conservative treatment for over 6 months, 3) without disc degeneration in lumbar MRI, 4) without instability in lateral flexion-extension view. The average age was 23 years and the follow-up periods ranged from 12 months to 54 months, mean 25 months. We confirmed union of defect and loosening or breakage of screws in preoperative, postoperative and the final radiographs, and in bone SPECT. And we analyzed symptomatic improvement by subjective assessment guidelines of Henderson clinically.
RESULTS
Radiologically, union of defect by trabeculation was seen in 8 patients, in 2 patients unilaterally. In bone SPECT, union of defect was seen in 5 cases among 7 cases postoperatively. Average periods of union were 3.1 months(2.5-6.2 months). There was no loosening of screws, but in 1 patient breakage of screws and nonunion was seen 8 months postoperatively. Clinically, 10 patients(83.3%) were rated as excellent or good-5 patients excellent, 5 patients good-according to subjective assessment guidelines of Henderson.
CONCLUSION
It is suggested that Buck's operation, one of the method of treatment of spondylolysis is simple and has low complication rate. We concluded that it is satisfactory to use Buck's operation in young patients with symptomatic spondylolysis.