Utilization of robotic pars repair for early return to activity in adolescents with symptomatic spondylolysis: a case series.

Overview

abstract

OBJECTIVE: Although the mainstay of treatment for lumbar spondylolysis is nonoperative management with activity modification, a sizeable portion of patients will go on to nonunion. The growing use of robotic surgical guidance can allow for placement of pars screws through percutaneous incisions. The objective of this case series was to report on the largest series of adolescent patients with lumbar spondylolysis treated with robot-assisted pars repair to date. METHODS: A retrospective review of a prospectively collected database was performed for all adolescent patients (aged 13-25 years) who underwent pars repairs for treatment of spondylolysis with a single-screw technique. Patient demographic, surgical, and postoperative course information was collected and reported. RESULTS: Nine patients who underwent robotic pars repair were identified. The mean ± SD duration of activity cessation at initial surgical consultation was 8.6 ± 10.6 months. Seven patients underwent bilateral pars repairs and 2 underwent unilateral pars repairs. With a mean ± SD follow-up of 11.4 ± 9.1 months, 78% of patients had either returned to their baseline activity or were cleared for return to sport at the time of final follow-up. CONCLUSIONS: For patients who fail nonoperative management, robot-assisted pars repair can be a safe and effective treatment option to allow return to activity in as little as 8 weeks. A single screw placed in a lag-by-technique fashion may be as clinically efficacious as open debridement and bone grafting described in prior literature.