A new technique of lysis repair described (2010) & published (2012) by Prof. Mohamed Mohi Eldin

1. Mohamed Mohi Eldin
Professor of Neurosurgery
Cairo University
Egypt

3. Repetitive stress on pars
(isthmus)
Loading and unloading
(repetitive spinal motion)
flexion extension
rotation
during physical activity.

4. Bilateral acute pars
fractures with hazy
irregular edges
Bilateral chronic pars
fracture with well-corticated
edges & spina bifida occulta

6. 6-month follow-up showing
partial bony union
1-year follow-up showing
complete bony union

16. Using 4.5 mm cortical screws and
cancellous bone grafting

27. Young patients
back pain alone
No neurological deficits
Failure of conservative treatment
Pars block test
Significant pain relief from wearing a plaster-corset

29. We have accepted a forward slip of
not more than 2mm as seen on
lateral standing roentgenograms

33. A standardized fluoroscopically guided protocol
Don’t violate the facet capsule
Defect localized bilaterally
Two top-loading titanium pedicle screws, one into
each pedicle, at the same level as the pars defect.

34. Simplifies visualization required for screw placement
allows minimal skin and muscle dissection

38. Postoperative X-ray show excellent over-
bridging of the defect zone, confirmed by CT.
The clinical outcome seems to be good.

39. More stiffness to flexion loads,
Larger area available for bone grafting,
Less need for postoperative immobilization.

41. Fast return to full activity
No postoperative pain
No late breakdowns in non-sporting patients.

42. Fusion of the pars defect and
Restoration of normal motion
in patients with
lumbar spondylolysis

43. When there is no evidence of
frank spondylolisthesis or
pain does not radiate below the knee
In patients younger than 30 years of age.