Repair of Pars Interarticularis Defect With a Modified Cable-Screw Construct

Operative treatment of symptomatic spondylolysis is not common. Multiple surgical techniques have been described for direct repairs of the pars defects. Reported success rates are high, although few reports describe successful return to sports in athletes. The purpose of the study was to assess the outcome after bone grafting and fixation of pars interarticularis defects utilizing a modification  of the previously described techniques of Scott and of Songer. A retrospective single-arm cohort study was performed at a single center. This article reports on three athletes with symptomatic spondylolysis or grade I spondylolisthesis unresponsive to conservativemanagement who were treated with bone grafting and a screw-cable repair. The outcome measure was the return to sports activities. A retrospective chart and radiographic analysis was conducted on three athletes. Patients were assessed for return to sports, clinical evidence of return to functional activities, and radiographic evidence of healing of the pars defects. All three patients proceeded to radiographic and clinical success. All patients reported resolution of their preoperative pain and return to sports. One patient did require occasional anti-inflammatory drugs for episodic low back pain. The use of this modified cable-screw technique for symptomatic spondylolysis provided excellent clinical, radiographic, and functional results in this small cohort. (Journal of Surgical Orthopaedic Advances 16(2):79–83, 2007)