A novel radiation-free technique for navigated direct pars repair in patients with spondylolysis and congenital vertebral anomalies: A report of two cases

Pars defects affect up to 7 % of adults. Patients with pars defects often experience progressively worsening pain and some develop spinal deformity due to the development of lytic spondylolisthesis. In symptomatic pars fractures who have failed non-operative management and have only mild deformity and degeneration, a decision can be made to fuse the affected motion segment or perform a direct pars repair. The purpose of this study is to describe a novel technique for direct pars repair using a novel radiation-free stereotactic navigation. We further describe the clinical outcomes in two cases managed with this technique. Two adult patients with L5 spondylolysis and spina bifida occulta − a 33-year-old male and a 41-year-old male who also had sacral dysraphism − underwent direct pars repair using radiation-free 7D Navigation. Both cases demonstrated clinical improvement and good radiographic outcomes at more than 1 year follow-up. Direct pars repair using radiation-free stereotactic navigation offers a safe, effective, and more efficient means for the surgical treatment of symptomatic spondylolysis. This is especially true for patients with lumbosacral anatomical variability, in whom conventional techniques may lead to screw malpositioning, a need for revision surgery, and poor outcomes.