ArticleJournal of spine surgery (Hong Kong)2026
Posterior lumbar interbody fusion (PLIF) combined with pars repair using a U-shaped rod technique for two-level lumbar spondylolysis: case report and technical note.
Article in Journal of spine surgery (Hong Kong), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Multi-level lumber spondylolysis is a rare clinical condition. In a surgical case, a surgical strategy gets complicated and needs to be tailored to each. We report a case of L4 and L5 spondylolysis with L4-5 spondylolisthesis successfully treated using the U-shaped rod technique. Case Description: The patient experienced low back and right lower leg pain. Neurological imaging revealed L4-5 spondylolytic spondylolisthesis, resulting in right foraminal stenosis and L4 root compression. L5 spondylolysis without slipping was observed. We performed L4-5 posterior interbody fusion and L5 pars repair using a U-shaped rod; L4 and L5 bilateral pedicle screws were inserted and connected by a U-shaped rod hooked to the L5 spinous process. Post-surgery, L4-5 slip and L5 pars defects were reduced and stabilized, with improved neurological symptoms. Conclusions: L4-5-S fusion was unnecessary for L5-S lesions without instability or foraminal stenosis. Simple fusion surgery had a subsequent negative effect on L5 spondylolysis. Therefore, we devised a fusion surgery and spondylolysis repair combination using a U-shaped rod that preserved L5-S mobility and L4-5 stability. The U-shaped rod technique is a surgical method for multilevel spondylolysis and is minimally invasive, readily available, simple, and effective. It is suitable for symptomatic proximal spondylolisthesis and asymptomatic distal spondylosis.
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