Minimal invasive fixation of pars interarticularis fracture: A case report

Abstract

Background: Pars interarticularis stress fracture usually causes mechanical lower back pain with extension activities, which may need orthopedics intervention. Many different techniques for pars repair have been proposed, with significant differences between the methods regarding their difficulty and the postoperative results. Case presentation: A 20-year-old professional football player presented to our spine clinic with a history of chronic upper lumbar back pain that has been affecting his activities of daily living. Clinical examination of the patient was positive for tenderness and spasms of the paraspinal muscles of the lumbar region, with normal lower limbs neurological examination. Intervention and outcome: Radiological evaluation of the lumbar spine confirmed the presence of bilateral L2 pars interarticularis stress fracture. After the failure of conservative measures, the patient underwent surgical fixation of the pars defect. Fixation of the defect was done with the use of bilateral small locking compression plates with screws. During follow-up, a CT scan showed complete bone healing at six months postoperatively. The patient returned to his normal activities and participation in football games eight months after the surgery. Conclusion: Fixation of the pars interarticularis fracture with a minimal locking compression plate is a feasible approach that can be achieved through a minimally invasive spine technique with no significant complications.