الفهرس 
SURGICAL ANATOMYOnly 14 pages are availabe for public view
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Abstract
S
pondylolysis is a unilateral or bilateral defect in the pars interarticularis of the vertebra and is usually due to acute or repetitive microtrauma. The incidence of spondylolysis is estimated to be 6%–7% in the general adult population.
In young athletes, pars injuries occur with a much greater incidence, reported at anywhere from 23%–63%. These frac¬tures are also observed twice as frequently in men com¬pared to women.
Direct pars repair is employed to prevent the natural loss in range of motion associated with fusion. Various techniques are less invasive than Buck’s fusion. The strengths of the direct repair include fewer complications than fusion, simplicity, good functional and radiographic outcomes, and good range of motion.
As most patients are younger adult and teenage athletes, they typically have a fast recovery and are able to return to sports conditioning within 6 months of their operations.
The best results have been reported in young male patients with single level pars defect who were treated early with direct repair.
We included 24 articles in qualitative analysis and quantitative meta-analysis.
We found overall outcome success rate was 84.4%, overall return to sport rate was 84.3% and overall complications rate was 6.5%
For a young athlete with a symptomatic pars defect, any of the described techniques of repair will probably produce acceptable results. An appropriate preoperative workup is important. The ideal candidate is younger than 20 years of age with minimal or no listhesis and no degenerative changes of the disc. Limited participation in sports can be expected from 5 to 12 months postoperatively. Familiarity with the various fixation techniques and anticipation of the anatomical variations will allow the surgeon to select the most appropriate surgical technique for repairing lytic defects in the lumbar spine.