Bilateral L3 Spondylolysis. A Case Report and an Overview of Spondylolytic Defect Repair Techniques

Abstract

The direct fusion methods for repair of spondylolytic defects of the lumbar spine have recently been replaced by transpedicular screw fixation of the affected segment, in combination with PLIF, TLIF or ALIF procedures. However, in clearly indicated cases, such as a younger patient with no intervertebral disc degeneration and only minimal or no displacement of the vertebra, the direct repair techniques have a great advantage over transpedicular fixation because they preserve segmental motion The paper reports on a patient with spondylolysis at L3 who underwent surgery combining the Tokuhashi and Matsuzaki and the Gillet and Petit techniques, which involved a system of transpedicular screws, rods and sublaminar hooks supplemented with a cross-connector to support the base of the spinous process. After surgery, the patient reported pain relief and return to normal activities and CT examination showed bony union of both spondylolytic defects.