Bucks fusion.

摘要

There are two major types of surgical procedures for spondylolysis, direct repair for a defect of the pars inter-articularis and posterolateral fusion. Pars repair preserves segmental motion and is a less aggressive approach than lumbosacral fusion. Pars repair is thus preferred for patients with a painful spondylolysis without a degenerative caudal disc or an associated slip.The pain generator in a patient with spondyloysis may be the pars defect, degenerated caudal disc, or of an unrelated pathology. Hence it is imperative that the pars defect be identified as the pain generator prior to undertaking this procedure. A diagnostic pars block is performed by infiltration of 0.2-0.3 ml of 2% lidocaine into each pars defect and observing for relief of lumbago. A positive test (relief of lumbago) is an indication of the lysis as the pain source.