Application of a new anatomic hook-rod-pedicle screw system in young patients with lumbar spondylolysis: A pilot study

doi:10.12998/wjcc.v10.i17.5680

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World Journal of Clinical Cases

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World J Clin Cases. Jun 16, 2022; 10(17): 5680-5689
Published online Jun 16, 2022. doi: 10.12998/wjcc.v10.i17.5680

Application of a new anatomic hook-rod-pedicle screw system in young patients with lumbar spondylolysis: A pilot study

Bao-Gan Peng, Wei Jiang, Yong-Chao Li, Duan-Ming Li

Duan-Ming Li, Yong-Chao Li, Bao-Gan Peng, Department of Orthopaedics, The Third Medical Center of PLA General Hospital, Beijing 100039, China

Wei Jiang, Department of Anesthesiology, The Third Medical Center of PLA General Hospital, Beijing 100039, China

Author contributions: Li DM and Jiang W designed the study; Peng BG wrote the manuscript text; Li DM and Peng BG performed the surgical operations; Li DM and Li YC contributed to critical revision; Peng BG and Jiang W contributed equally to this work; All authors reviewed the manuscript and approved the final version.

Institutional review board statement: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the ethics committee of The Third Medical Centre of Chinese PLA General Hospital.

Informed consent statement: Informed written consent was obtained from the patients for publication of this manuscript and any accompanying images.

Conflict-of-interest statement: The authors declare that they have no financial or other conflicts of interest in relation to this research and its publication.

Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.

Corresponding author: Bao-Gan Peng, MD, PhD, Department of Orthopaedics, The Third Medical Center of PLA General Hospital, No. 69 Yongding Road, Beijing 100039, China. pengbaogan76611@163.com

Received: October 23, 2021
Peer-review started: October 23, 2021
First decision: January 22, 2022
Revised: March 28, 2022
Accepted: April 20, 2022
Article in press: April 20, 2022
Published online: June 16, 2022
Processing time: 228 Days and 17.5 Hours

ARTICLE HIGHLIGHTS

Research background

The pedicle screw-laminar hook system has strong fixation and is conducive to bone graft fusion for lumbar spondylolysis. However, the current pedicle screw-laminar hook fixation system is not specifically designed for lumbar spondylolysis.

Research motivation

The pedicle screw-laminar hook system currently in use is not specifically designed for the treatment of lumbar spondylolysis. It has some disadvantages, such as incomplete matching between hook and lamina, difficulty in installation between rod and pedicle screw and large trauma. Complete exposure of the lamina is usually required, resulting in excessive paraspinal soft tissue dissection.

Research objectives

To investigate the clinical effects of a new anatomical hook-rod-pedicle screw system in the treatment of lumbar spondylolysis in young adults.

Research methods

We designed a new anatomic hook-rod-pedicle screw system for young patients with lumbar spondylolysis. The isthmus and the corresponding pedicle screw entry point were exposed through the intermuscular approach. Autogenous iliac bone graft was obtained to bridge the isthmus defect, and then the anatomic hook-rod-pedicle screw system was used to fix the isthmus in 15 young patients.

Research results

At 24 mo follow-up, the visual analogue scale score of low back pain decreased from 6.73 ± 0.88 to 0.73 ± 0.59, and the Oswestry disability index score decreased from 58.20 ± 8.99 to 7.87 ± 4.97. Computed tomography showed bilateral isthmic bone healing in 14 cases and unilateral isthmic bone healing in 1 case. Magnetic resonance imaging showed that the lumbar disc signal of the diseased segment and adjacent segments had no change compared with that before surgery. The pain visual analogue scale score of the donor site was 0.20 ± 0.41 at the last follow-up. According to the Modified Macnab score, the excellent and good rate was 100%.

Research conclusions

The application of this new anatomical hook-rod-pedicle screw system to treat young patients with lumbar spondylolysis has the advantages of less trauma, a simple operation and satisfactory clinical effects.

Research perspectives

The new anatomical hook-rod-pedicle screw system should be evaluated in a large sample multicenter randomized controlled study.