Special Technical ArticlesRepair of Pars Interarticularis Defect Utilizing a Pedicle and Laminar Screw Construct: A Technique Discussion and Case SeriesSnowden, Ryan MD; Sasso, Rick MDAuthor Information Indiana Spine Group, Carmel, IN R. Sasso: Cerapedics: research support; Cervical Spine Research Society: board or committee member; Journal of Spinal Disorders and Technique Spine Arthroplasty Society Journal: editorial or governing board; Medtronic: IP royalties; research support; Parexel: research support; Relievant: research support; Saunders/Mosby-Elsevier: publishing royalties, financial, or material support; Smith & Nephew: research support; Spinal Kinetics: research support; Stryker: research support. R. Snowden declare that there is nothing to disclose. For reprint requests, or additional information and guidance on the techniques described in the article, please contact Ryan Snowden, MD, at [email protected] or by mail at Indiana Spine Group, Carmel, 13225 North Meridian Street, Carmel, IN 46033. You may inquire whether the author(s) will agree to phone conferences and/or visits regarding these techniques. Techniques in Orthopaedics: March 2021 - Volume 36 - Issue 1 - p 40-44 doi: 10.1097/BTO.0000000000000382 Buy Metrics Abstract Introduction: Lumbar isthmic spondylolysis is a common disorder in young adults and adolescents. Following failure of nonoperative measures, multiple nonfusion techniques have been described to repair the spondylotic defect with varying results. Recently a new pedicle screw-laminar screw construct has been described and found comparable to other pedicle screw constructs in biomechanical testing. We describe the use of the pedicle screw-lamina screw constructs using image guidance and 3-dimensional imaging in the surgical management of isthmic spondylolysis. We also present a case series of patients undergoing treatment of isthmic spondylolysis. All patients undergoing pedicle screw-laminar screw pars repair construct from 2012 to 2017 by the senior author. Materials and Methods: All patients undergoing pedicle screw-laminar screw pars repair by the senior author from 2012 to 2017 were included. Patients were excluded for spondylolisthesis, disc degeneration at the level of spondylolysis, advanced age (>25), evidence of nerve root compression or significant signs of degenerative osteoarthritis. All patients failed a standardized course of nonoperative treatment before surgery. Patients were followed until full, pain-free activity had resumed. Six patients successfully underwent pedicle screw-laminar screw pars repair using intraoperative computed tomography guidance. There were no intraoperative or postoperative complications. All patients returned to full athletic activity at an average of 5.17 months. Final radiographs showed complete or near complete resolution of the defect in all cases. We are the first to describe the use of the pedicle screw-lamina screw constructs using image guidance and 3-dimensional imaging in the surgical management of isthmic spondylolisthesis in a clinical situation. The combination of pedicle screw and laminar screw provides a construct with robust fixation while allowing for ample bone grafting surface area. Furthermore, the utilization of intraoperative navigations provides an added measure of safety when placing both screws. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.