World neurosurgery | 2021
Spondylolysis repair using a minimally-invasive modified Buck technique with neuro-navigation and neuro-monitoring in high-school and professional athletes: technical notes, case series and literature review.
Abstract
Spondylolysis is a defect in the pars interarticularis of the vertebra, frequently diagnosed in high-school athletes. Although nonsurgical management is the mainstay of treatment, surgery is an option for patients with persistent symptoms despite multiple cycles of nonsurgical treatment. Performing minimally-invasive surgery reduces complications, post-operative pain, and hospitalization time, resulting in quicker recovery. This paper reports post-operative results in two high-school athletes and one professional athlete treated using a minimally-invasive modified Buck technique. All were between 17 and 18 years old and had been managed non-surgically for at least 12 months (range = 12-36 months). All had bilateral spondylolysis, one at L3 and two at L5. Surgery was performed using a minimally-invasive, modified Buck technique and cannulated compression screws, supported by neuro-navigation and neuro-monitorization. All underwent rehabilitative therapy and were followed for at least six months, ultimately undergoing computed tomography which confirmed complete consolidation and fixation within four months. Within six months, all had experienced total resolution of their pain and had returned to their previous athletic activities at their pre-injury level. None experienced any complications. In conclusion, in young athletes, the proposed minimally-invasive modified Buck technique provided all the advantages of minimally-invasive surgery, while achieving complete consolidation and an early return to sporting activities without complications.