Smiley Rod Technique for Direct Pars Repair in Patients with Symptomatic Lumbar Spondylolysis: A Prospective Case Series.
Year: 2026
Type: article
Abstract: Introduction: Lumbar spondylolysis is a common cause of chronic low back pain in adolescents and young adults. Although most patients improve with conservative treatment, persistent symptoms may require surgery. Fusion provides stability but sacrifices segmental motion. Direct pars repair aims to restore pars continuity while preserving mobility. This study evaluated clinical and radiological outcomes of the Smiley Rod technique for symptomatic L5 spondylolysis. Materials and Methods: This prospective case series included ten patients aged 18-40 years with symptomatic L5 pars defects who failed at least 6 months of conservative management. Patients with Grade II or higher spondylolisthesis, significant disc degeneration, spinal canal stenosis, infection, or previous lumbar surgery were excluded. All patients underwent direct pars repair using the Smiley Rod technique. Visual Analog Scale (VAS) and Oswestry disability Index (ODI) scores were recorded preoperatively and at 3 months, 6 months, and 1 year. Computed tomography was used to assess pars fusion at 1 year. Result: The mean pre-operative VAS score improved from 6.1 ± 0.7 to 1.3 ± 0.4 at 1 year. Mean ODI improved from 58.4% ± 6.2% preoperatively to 14.8% ± 3.6% at final follow-up. Complete pars fusion was seen in six patients and partial fusion in four. All patients returned to routine activities within 6 months. No implant-related complications, neurological deficits, surgical site infections, or adjacent segment degeneration were observed. Conclusion: The smiley rod technique appears to be a safe and effective motion-preserving option for selected patients with symptomatic L5 spondylolysis, with favorable short-term clinical and radiological outcomes.
Source: PubMed
Language: English
Subfield: Orthopedics and Sports Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7225569894
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