Advances in surgical navigation may be breathing new life into an older spine technique, one spine surgeon says.
The case study, published Jan. 3 in Interdisciplinary Neurosurgery, focused on two adult patients with L5 spondylolysis and spina bifida occults. Both underwent a direct pars repair using radiation-free 7D navigation.
Both cases saw clinical improvement and good radiographic outcomes after more than a year of follow up. The study concluded that direct pars repair with radiation-free navigation was a safe, effective and efficient option for symptomatic spondylolysis.
Maahir Haque, MD, an author on the study, said that while pars fractures usually affect adolescents, some of them may develop lytic spondylolisthesis later in life.
“It’s a pretty common condition that is fixed or managed later on in life with a spine fusion,” he told Becker’s. “Typically, the treatment is spine fusion. What I have been doing research into, and what we’ve been doing in my practice, is adopting the old techniques for pars repair and pairing them with some of our newer enabling technologies. Navigation allows us to go in and repair these pars fractures. In some cases the benefit is you maintain motion at that spinal level.”
Looking ahead, Dr. Haque hopes to see more improvements in the screws that can be used for these cases.
“I often use hydroxyapatite coated screws when I can get one in,” Dr. Haque said. “Currently, the smallest hydroxyapatite screws are about 4.5 millimeters, and a few vendors have them. But I firmly believe that we could do a better job of developing a more specific instrumentation for this procedure. We could most likely adopt a currently used screw for this technique, because currently there is no FDA-approved method for the implant in this procedure.”
Advancing nanotechnology and other proprietary screws to get better purchase in the bone fragments is another area with potential for innovation, Dr. Haque said.
