Pedicle Screw/Sublaminar Hook Fixation versus Pedicle Screw/Infraspinous Wire Fixation for Spondylolysis Repair: A Retrospective Comparative Study with MSCT Assessment

Abstract

Background Data: Spondylolysis is a stress fracture of the pars interarticularis that occurs in 2–5% of the population. Surgical techniques of spondylolysis repair have been challenging in the last decades. Purpose: To compare pedicle screw-hook and pedicle screw-infraspinous wire fixation in pars repair clinically and radiologically. Study Design: Retrospective comparative clinical case study. Patients and Methods: Twenty-four patients with pars repair using pedicle screw-hook fixation (group I) compared with 21 patients using pedicle screw-infraspinous wire fixation (group II) were reported. Autogenous iliac bone grafting was performed in both groups. Two cases in group I had concomitant unilateral laminolysis with hypertrophied nonunion. All patients were assessed for back pain visual analog score (VAS) and Oswestry disability index (ODI) preoperatively. Clinical follow-up was conducted at 3, 6, 9, and 12 months using VAS and ODI. Union was assessed using multislice CT. Results: At the final follow-up, back pain VAS and ODI improved significantly in both groups (P Conclusion: Both pedicle screw-sublaminar hook and pedicle screw-infraspinous wire fixation plus autogenous bone graft have satisfactory outcomes in spondylolysis repair. Using screw-hook construct was associated with significant earlier union, and could be considered a good choice for combined spondylolysis and laminolysis.