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Pars Repair for Spondylolysis

Children's Mercy is an American College of Surgeons Verified Center

Spondylolysis is a defect or fracture in the pars interarticularis of the lumbar vertebrae. It is most commonly located at the L5 vertebra in the lower back but can also be located at other levels of the spine. Spondylolysis can occur as a result of overuse or injury, as well as from a congenital predisposition, and can be a cause of back pain.

The pars repair procedure is a minimally invasive and is utilized when your child has persistent symptoms over 6 months despite strict activity modification as directed by a health care provider. This procedure has the advantage of motion preservation in the back when compared to a spine fusion.

Your surgeon will be able to discuss what procedure is best for your child based on the quality of the pars defect. The goal of the procedure is to treat the pain and return your child to their daily activity.

How the procedure works

The spine is operated on through a small incision made on the lower back. The defect is repaired by placing a strong titanium screw through the pars in order to bridge the two sides of the fracture back together, allowing for healing and stabilization. A bone graft may also be used for further support of the area.

A pars repair will often take 3 hours in the operating room. After the procedure, your child may spend 1-2 days in the hospital.

Your surgeon will discuss what limitations of activity they would like for your child to follow once surgery has been completed. Bracing is usually not necessary after surgery.

Recovering from a pars repair

Rest is crucial in allowing the back to heal so your child may return to their pre-surgery level of function. Your child’s care team will follow them after surgery and below are typical restrictions for your child while recovering from a pars repair procedure:

  • No school for 1-2 weeks
  • Limited sports and other rigorous exercise for 2-3 months

Your child will return to the Spine Care Clinic at 6 weeks after surgery for a follow-up with their surgeon. During this time, your child may be prescribed physical therapy to assist them in returning to their sport or other physical activities. It is important to follow the instructions provided by your child’s surgeon so your child can gradually be released back to activity as soon as safely possible.

Non-operative treatment for spondylolysis

Many children with lumbar spondylolysis can be treated without surgery through rest or break from sports, physical therapy, or a steroid injection at the pars defect through our Interventional Radiology department at Children’s Mercy. A lumbar brace that stops the trunk from over extension can also be prescribed also.