Skip to main content
SpringerLink
Log in

Repair of Pars Defects and Spondylosis

  • Chapter
  • First Online:
Essentials of Spinal Stabilization

  • 1281 Accesses

Abstract

Defects of the pars interarticularis are predominantly an acquired condition, most often occurring at the L5 level and increasing in prevalence from adolescence to adulthood. On plain lumbar x-rays, the “scotty dog” sign can be diagnostic in 95% of spondylolysis cases. Pars defects can result in debilitating mechanical back pain and degenerative changes that predispose to the development of spondylolisthesis. In the absence of a mobile spondylolisthesis, operative management is indicated in cases of neurological compromise or those who have failed extensive conservative management including reduced activities that promote hyperextension and load bearing. Direct pars defect repair can be performed using pedicle screws attached to sublaminar hooks, Buck’s procedure of laminar screw placement through the defect into the ipsilateral pedicle, and wire fixation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Belfi LM, Ortiz AO, Katz DS. Computed tomography evaluation of spondylolysis and spondylolisthesis in asymptomatic patients. Spine. 2006;31(24):E907–10.

    Article  PubMed  Google Scholar 

  2. Harvey CJ, Richenberg JL, Saifuddin A, Wolman RL. The radiological investigation of lumbar spondylolysis. Clin Radiol. 1998;53(10):723–8.

    Article  CAS  PubMed  Google Scholar 

  3. Gurd DP. Back pain in the young athlete. Sports Med Arthrosc. 2011;19(1):7–16.

    Article  PubMed  Google Scholar 

  4. Fredrickson BE, Baker D, McHolick WJ, Yuan HA, Lubicky JP. The natural history of spondylolysis and spondylolisthesis. J Bone Joint Surg Am. 1984;66(5):699–707.

    Article  CAS  PubMed  Google Scholar 

  5. Beutler WJ, Fredrickson BE, Murtland A, Sweeney CA, Grant WD, Baker D. The natural history of spondylolysis and spondylolisthesis: 45-year follow-up evaluation. Spine. 2003;28(10):1027–35. discussion 35

    PubMed  Google Scholar 

  6. Cassidy RC, Shaffer WO, Johnson DL. Spondylolysis and spondylolisthesis in the athlete. Orthopedics. 2005;28(11):1331–3.

    PubMed  Google Scholar 

  7. Toueg CW, Mac-Thiong JM, Grimard G, Parent S, Poitras B, Labelle H. Prevalence of spondylolisthesis in a population of gymnasts. Stud Health Technol Inform. 2010;158:132–7.

    PubMed  Google Scholar 

  8. Terai T, Sairyo K, Goel VK, Ebraheim N, Biyani A, Faizan A, et al. Spondylolysis originates in the ventral aspect of the pars interarticularis: a clinical and biomechanical study. J Bone Joint Surg Br. 2010;92(8):1123–7.

    Article  CAS  PubMed  Google Scholar 

  9. Wiltse LL. The etiology of spondylolisthesis. J Bone Joint Surg Am. 1962;44-A:539–60.

    Article  CAS  PubMed  Google Scholar 

  10. Dunn AJ, Campbell RS, Mayor PE, Rees D. Radiological findings and healing patterns of incomplete stress fractures of the pars interarticularis. Skelet Radiol. 2008;37(5):443–50.

    Article  Google Scholar 

  11. Foreman P, Griessenauer CJ, Watanabe K, Conklin M, Shoja MM, Rozzelle CJ, et al. L5 spondylolysis/spondylolisthesis: a comprehensive review with an anatomic focus. Childs Nerv Syst. 2013;29(2):209–16.

    Article  PubMed  Google Scholar 

  12. Lonstein JE. Spondylolisthesis in children. Cause, natural history, and management. Spine. 1999;24(24):2640–8.

    Article  CAS  PubMed  Google Scholar 

  13. Niethard FU, Pfeil J, Weber M. Etiology and pathogenesis of spondylolytic spondylolisthesis. Orthopade. 1997;26(9):750–4.

    Google Scholar 

  14. Albanese M, Pizzutillo PD. Family study of spondylolysis and spondylolisthesis. J Pediatr Orthop. 1982;2(5):496–9.

    Article  CAS  PubMed  Google Scholar 

  15. Wynne-Davies R, Scott JH. Inheritance and spondylolisthesis: a radiographic family survey. J Bone Joint Surg Br. 1979;61-B(3):301–5.

    CAS  PubMed  Google Scholar 

  16. Seitsalo S, Osterman K, Hyvarinen H, Tallroth K, Schlenzka D, Poussa M. Progression of spondylolisthesis in children and adolescents. A long-term follow-up of 272 patients. Spine. 1991;16(4):417–21.

    Article  CAS  PubMed  Google Scholar 

  17. Kasliwal MK, Smith JS, Kanter A, Chen CJ, Mummaneni PV, Hart RA, et al. Management of high-grade spondylolisthesis. Neurosurg Clin N Am. 2013;24(2):275–91.

    Article  PubMed  Google Scholar 

  18. Hammerberg KW. New concepts on the pathogenesis and classification of spondylolisthesis. Spine. 2005;30(6 Suppl):S4–11.

    Article  PubMed  Google Scholar 

  19. Hresko MT, Labelle H, Roussouly P, Berthonnaud E. Classification of high-grade spondylolistheses based on pelvic version and spine balance: possible rationale for reduction. Spine. 2007;32(20):2208–13.

    Article  PubMed  Google Scholar 

  20. Mac-Thiong JM, Duong L, Parent S, Hresko MT, Dimar JR, Weidenbaum M, et al. Reliability of the spinal deformity study group classification of lumbosacral spondylolisthesis. Spine. 2012;37(2):E95–102.

    Article  PubMed  Google Scholar 

  21. Mac-Thiong JM, Labelle H, Parent S, Hresko MT, Deviren V, Weidenbaum M, et al. Reliability and development of a new classification of lumbosacral spondylolisthesis. Scoliosis. 2008;3:19.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Kim HJ, Green DW. Adolescent back pain. Curr Opin Pediatr. 2008;20(1):37–45.

    Article  PubMed  Google Scholar 

  23. Micheli LJ, Wood R. Back pain in young athletes. Significant differences from adults in causes and patterns. Arch Pediatr Adolesc Med. 1995;149(1):15–8.

    Article  CAS  PubMed  Google Scholar 

  24. Standaert CJ, Herring SA. Expert opinion and controversies in sports and musculoskeletal medicine: the diagnosis and treatment of spondylolysis in adolescent athletes. Arch Phys Med Rehabil. 2007;88(4):537–40.

    Article  PubMed  Google Scholar 

  25. Tsirikos AI, Garrido EG. Spondylolysis and spondylolisthesis in children and adolescents. J Bone Joint Surg Br. 2010;92(6):751–9.

    Article  CAS  PubMed  Google Scholar 

  26. Smith JA, Hu SS. Management of spondylolysis and spondylolisthesis in the pediatric and adolescent population. Orthop Clin North Am. 1999;30(3):487–99. ix

    Article  CAS  PubMed  Google Scholar 

  27. Herman MJ, Pizzutillo PD, Cavalier R. Spondylolysis and spondylolisthesis in the child and adolescent athlete. Orthop Clin North Am. 2003;34(3):461–7. vii

    Article  PubMed  Google Scholar 

  28. Rapala K, Jagielak MJ. A case of Phalen-Dickson syndrome. Wiad Lek. 1992;45(23–24):931–3.

    CAS  PubMed  Google Scholar 

  29. Barash HL, Galante JO, Lambert CN, Ray RD. Spondylolisthesis and tight hamstrings. J Bone Joint Surg Am. 1970;52(7):1319–28.

    Article  CAS  PubMed  Google Scholar 

  30. Arlet V, Rigault P, Padovani JP, Touzet P, Finidori G, Guyonvarch G. Scoliosis, spondylolysis and lumbosacral spondylolisthesis. A study of their association apropos of 82 cases in children and adolescents. Rev Chir Orthop Reparatrice Appar Mot. 1990;76(2):118–27.

    CAS  PubMed  Google Scholar 

  31. Bozdech Z. Scoliosis and spondylolisthesis. Acta Chir Orthop Traumatol Cechoslov. 1962;29:224–8.

    CAS  Google Scholar 

  32. Chang KW, McAfee PC. Degenerative spondylolisthesis and degenerative scoliosis treated with a combination segmental rod-plate and transpedicular screw instrumentation system: a preliminary report. J Spinal Disord. 1988;1(4):247–56.

    CAS  PubMed  Google Scholar 

  33. Fisk JR, Moe JH, Winter RB. Scoliosis, spondylolysis, and spondylolisthesis. Their relationship as reviewed in 539 patients. Spine. 1978;3(3):234–45.

    Article  CAS  PubMed  Google Scholar 

  34. Mau H. Scoliosis and spondylolysis-spondylolisthesis. Arch Orthop Trauma Surg. 1981;99(1):29–34.

    Article  CAS  PubMed  Google Scholar 

  35. Lenke LG, Bridwell KH. Evaluation and surgical treatment of high-grade isthmic dysplastic spondylolisthesis. Instr Course Lect. 2003;52:525–32.

    PubMed  Google Scholar 

  36. Miller SF, Congeni J, Swanson K. Long-term functional and anatomical follow-up of early detected spondylolysis in young athletes. Am J Sports Med. 2004;32(4):928–33.

    Article  PubMed  Google Scholar 

  37. Alvarez-Diaz P, Alentorn-Geli E, Steinbacher G, Rius M, Pellise F, Cugat R. Conservative treatment of lumbar spondylolysis in young soccer players. Knee Surg Sports Traumatol Arthrosc. 2011;19(12):2111–4.

    Article  PubMed  Google Scholar 

  38. Iwamoto J, Sato Y, Takeda T, Matsumoto H. Return to sports activity by athletes after treatment of spondylolysis. World J Orthod. 2010;1(1):26–30.

    Article  Google Scholar 

  39. Iwamoto J, Takeda T, Wakano K. Returning athletes with severe low back pain and spondylolysis to original sporting activities with conservative treatment. Scand J Med Sci Sports. 2004;14(6):346–51.

    Article  CAS  PubMed  Google Scholar 

  40. Debnath UK, Freeman BJ, Grevitt MP, Sithole J, Scammell BE, Webb JK. Clinical outcome of symptomatic unilateral stress injuries of the lumbar pars interarticularis. Spine. 2007;32(9):995–1000.

    Article  PubMed  Google Scholar 

  41. El Rassi G, Takemitsu M, Woratanarat P, Shah SA. Lumbar spondylolysis in pediatric and adolescent soccer players. Am J Sports Med. 2005;33(11):1688–93.

    Article  PubMed  Google Scholar 

  42. Sys J, Michielsen J, Bracke P, Martens M, Verstreken J. Nonoperative treatment of active spondylolysis in elite athletes with normal X-ray findings: literature review and results of conservative treatment. Eur Spine J. 2001;10(6):498–504.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. El Rassi G, Takemitsu M, Glutting J, Shah SA. Effect of sports modification on clinical outcome in children and adolescent athletes with symptomatic lumbar spondylolysis. Am J Phys Med Rehabil. 2013;92(12):1070–4.

    Article  PubMed  Google Scholar 

  44. Sutton JH, Guin PD, Theiss SM. Acute lumbar spondylolysis in intercollegiate athletes. J Spinal Disord Tech. 2012;25(8):422–5.

    Article  PubMed  Google Scholar 

  45. Menga EN, Kebaish KM, Jain A, Carrino JA, Sponseller PD. Clinical results and functional outcomes after direct intralaminar screw repair of spondylolysis. Spine. 2014;39(1):104–10.

    Article  PubMed  Google Scholar 

  46. Pizzutillo PD, Hummer CD 3rd. Nonoperative treatment for painful adolescent spondylolysis or spondylolisthesis. J Pediatr Orthop. 1989;9(5):538–40.

    Google Scholar 

  47. Pizzutillo PD, Mirenda W, MacEwen GD. Posterolateral fusion for spondylolisthesis in adolescence. J Pediatr Orthop. 1986;6(3):311–6.

    Article  CAS  PubMed  Google Scholar 

  48. Cavalier R, Herman MJ, Cheung EV, Pizzutillo PD. Spondylolysis and spondylolisthesis in children and adolescents: I. Diagnosis, natural history, and nonsurgical management. J Am Acad Orthop Surg. 2006;14(7):417–24.

    Article  PubMed  Google Scholar 

  49. Harris IE, Weinstein SL. Long-term follow-up of patients with grade-III and IV spondylolisthesis. Treatment with and without posterior fusion. J Bone Joint Surg Am. 1987;69(7):960–9.

    Article  CAS  PubMed  Google Scholar 

  50. Labelle H, Roussouly P, Berthonnaud E, Transfeldt E, O'Brien M, Chopin D, et al. Spondylolisthesis, pelvic incidence, and spinopelvic balance: a correlation study. Spine. 2004;29(18):2049–54.

    Article  PubMed  Google Scholar 

  51. Labelle H, Roussouly P, Berthonnaud E, Dimnet J, O'Brien M. The importance of spino-pelvic balance in L5-s1 developmental spondylolisthesis: a review of pertinent radiologic measurements. Spine. 2005;30(6 Suppl):S27–34.

    Article  PubMed  Google Scholar 

  52. Hu SS, Tribus CB, Diab M, Ghanayem AJ. Spondylolisthesis and spondylolysis. Instr Course Lect. 2008;57:431–45.

    PubMed  Google Scholar 

  53. Leone A, Cianfoni A, Cerase A, Magarelli N, Bonomo L. Lumbar spondylolysis: a review. Skelet Radiol. 2011;40(6):683–700.

    Article  Google Scholar 

  54. Amato M, Totty WG, Gilula LA. Imaging rounds #96. Spondylolysis—laminal fragmentation on the AP view. Orthop Rev. 1988;17(9):925–31.

    CAS  PubMed  Google Scholar 

  55. Amato M, Totty WG, Gilula LA. Spondylolysis of the lumbar spine: demonstration of defects and laminal fragmentation. Radiology. 1984;153(3):627–9.

    Article  CAS  PubMed  Google Scholar 

  56. Maldague BE, Malghem JJ. Unilateral arch hypertrophy with spinous process tilt: a sign of arch deficiency. Radiology. 1976;121(3 Pt. 1):567–74.

    Article  CAS  PubMed  Google Scholar 

  57. Meyerding HW. Spondylolisthesis; surgical fusion of lumbosacral portion of spinal column and interarticular facets; use of autogenous bone grafts for relief of disabling backache. J Int Coll Surg. 1956;26(5 Part 1):566–91.

    CAS  PubMed  Google Scholar 

  58. Tanguay F, Labelle H, Wang Z, Joncas J, de Guise JA, Mac-Thiong JM. Clinical significance of lumbosacral kyphosis in adolescent spondylolisthesis. Spine. 2012;37(4):304–8.

    Article  PubMed  Google Scholar 

  59. Glavas P, Mac-Thiong JM, Parent S, de Guise JA, Labelle H. Assessment of lumbosacral kyphosis in spondylolisthesis: a computer-assisted reliability study of six measurement techniques. Eur Spine J. 2009;18(2):212–7.

    Article  PubMed  Google Scholar 

  60. Nachemson A, Wiltse LL. Editorial: spondylolisthesis. Clin Orthop Relat Res. 1976;117:2–3.

    Google Scholar 

  61. Goyal N, Wimberley DW, Hyatt A, Zeiller S, Vaccaro AR, Hilibrand AS, et al. Radiographic and clinical outcomes after instrumented reduction and transforaminal lumbar interbody fusion of mid and high-grade isthmic spondylolisthesis. J Spinal Disord Tech. 2009;22(5):321–7.

    Article  PubMed  Google Scholar 

  62. Poussa M, Remes V, Lamberg T, Tervahartiala P, Schlenzka D, Yrjonen T, et al. Treatment of severe spondylolisthesis in adolescence with reduction or fusion in situ: long-term clinical, radiologic, and functional outcome. Spine. 2006;31(5):583–90. discussion 91-2

    Article  PubMed  Google Scholar 

  63. Poussa M, Schlenzka D, Seitsalo S, Ylikoski M, Hurri H, Osterman K. Surgical treatment of severe isthmic spondylolisthesis in adolescents. Reduction or fusion in situ. Spine. 1993;18(7):894–901.

    Article  CAS  PubMed  Google Scholar 

  64. Ruf M, Koch H, Melcher RP, Harms J. Anatomic reduction and monosegmental fusion in high-grade developmental spondylolisthesis. Spine. 2006;31(3):269–74.

    Article  PubMed  Google Scholar 

  65. Martiniani M, Lamartina C, Specchia N. “In situ” fusion or reduction in high-grade high dysplastic developmental spondylolisthesis (HDSS). Eur Spine J. 2012;21(Suppl 1):S134–40.

    Article  PubMed  Google Scholar 

  66. Pawar A, Labelle H, Mac-Thiong JM. The evaluation of lumbosacral dysplasia in young patients with lumbosacral spondylolisthesis: comparison with controls and relationship with the severity of slip. Eur Spine J. 2012;21(11):2122–7.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Boxall D, Bradford DS, Winter RB, Moe JH. Management of severe spondylolisthesis in children and adolescents. J Bone Joint Surg Am. 1979;61(4):479–95.

    Article  CAS  PubMed  Google Scholar 

  68. Kasliwal MK, Smith JS, Shaffrey CI, Saulle D, Lenke LG, Polly DW Jr, et al. Short-term complications associated with surgery for high-grade spondylolisthesis in adults and pediatric patients: a report from the scoliosis research society morbidity and mortality database. Neurosurgery. 2012;71(1):109–16.

    Article  PubMed  Google Scholar 

  69. Petraco DM, Spivak JM, Cappadona JG, Kummer FJ, Neuwirth MG. An anatomic evaluation of L5 nerve stretch in spondylolisthesis reduction. Spine. 1996;21(10):1133–8. discussion 9

    Article  CAS  PubMed  Google Scholar 

  70. Radcliff KE, Kalantar SB, Reitman CA. Surgical management of spondylolysis and spondylolisthesis in athletes: indications and return to play. Curr Sports Med Rep. 2009;8(1):35–40.

    Article  PubMed  Google Scholar 

  71. Logroscino G, Mazza O, Aulisa G, Pitta L, Pola E, Aulisa L. Spondylolysis and spondylolisthesis in the pediatric and adolescent population. Childs Nerv Syst. 2001;17(11):644–55.

    Article  CAS  PubMed  Google Scholar 

  72. Buck JE. Direct repair of the defect in spondylolisthesis. Preliminary report. J Bone Joint Surg Br. 1970;52(3):432–7.

    CAS  PubMed  Google Scholar 

  73. Tonino A, van der Werf G. Direct repair of lumbar spondylolysis. 10-year follow-up of 12 previously reported cases. Acta Orthop Scand. 1994;65(1):91–3.

    Article  CAS  PubMed  Google Scholar 

  74. Drazin D, Shirzadi A, Jeswani S, Ching H, Rosner J, Rasouli A, et al. Direct surgical repair of spondylolysis in athletes: indications, techniques, and outcomes. Neurosurg Focus. 2011;31(5):E9.

    Article  PubMed  Google Scholar 

  75. Widi GA, Williams SK, Levi AD. Minimally invasive direct repair of bilateral lumbar spine pars defects in athletes. Case Rep Med. 2013;2013:659078.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Songer M. Repair of the pars interarticularis defect with a cable-screw construct. Spine. 1998;23(2):284.

    Article  CAS  PubMed  Google Scholar 

  77. Morscher E, Gerber B, Fasel J. Surgical treatment of spondylolisthesis by bone grafting and direct stabilization of spondylolysis by means of a hook screw. Arch Orthop Trauma Surg. 1984;103(3):175–8.

    Article  CAS  PubMed  Google Scholar 

  78. Tokuhashi Y, Matsuzaki H. Repair of defects in spondylolysis by segmental pedicular screw hook fixation. A preliminary report. Spine. 1996;21(17):2041–5.

    Article  CAS  PubMed  Google Scholar 

  79. Hioki A, Miyamoto K, Sadamasu A, Nozawa S, Ogawa H, Fushimi K, et al. Repair of pars defects by segmental transverse wiring for athletes with symptomatic spondylolysis: relationship between bony union and postoperative symptoms. Spine. 2012;37(9):802–7.

    Article  PubMed  Google Scholar 

  80. Noggle JC, Sciubba DM, Samdani AF, Anderson DG, Betz RR, Asghar J. Minimally invasive direct repair of lumbar spondylolysis with a pedicle screw and hook construct. Neurosurg Focus. 2008;25(2):E15.

    Article  PubMed  Google Scholar 

  81. Patel RD, Rosas HG, Steinmetz MP, Anderson PA. Repair of pars interarticularis defect utilizing a pedicle and laminar screw construct: a new technique based on anatomical and biomechanical analysis. J Neurosurg Spine. 2012;17(1):61–8.

    Article  PubMed  Google Scholar 

  82. Li Y, Hresko MT. Lumbar spine surgery in athletes: outcomes and return-to-play criteria. Clin Sports Med. 2012;31(3):487–98.

    Article  PubMed  Google Scholar 

  83. Bohlman HH, Cook SS. One-stage decompression and posterolateral and interbody fusion for lumbosacral spondyloptosis through a posterior approach. Report of two cases. J Bone Joint Surg Am. 1982;64(3):415–8.

    Article  CAS  PubMed  Google Scholar 

  84. Gaines RW. L5 vertebrectomy for the surgical treatment of spondyloptosis: thirty cases in 25 years. Spine. 2005;30(6 Suppl):S66–70.

    Article  PubMed  Google Scholar 

  85. Gaines RW, Nichols WK. Treatment of spondyloptosis by two stage L5 vertebrectomy and reduction of L4 onto S1. Spine. 1985;10(7):680–6.

    Article  CAS  PubMed  Google Scholar 

  86. Papanastassiou ID, Jain S, Baaj AA, Eleraky M, Papagelopoulos PJ, Vrionis FD. Vertebrectomy and expandable cage placement via a one-stage, one-position anterolateral retroperitoneal approach in L5 tumors. J Surg Oncol. 2011;104(5):552–8.

    Article  PubMed  Google Scholar 

  87. Gandhoke GS, Kasliwal MK, Smith JS, Nieto JARN, Ibrahimi D, Park P, Lamarca F, Shaffrey C, Okonkwo DO, Kanter AS. A multicenter evaluation of clinical and radiographic outcomes following highgrade spondylolisthesis reduction and fusion. Clin Spine Surg. 2017;30(4):E363–9.

    Google Scholar 

  88. Tobler WD, Gerszten PC, Bradley WD, Raley TJ, Nasca RJ, Block JE. Minimally invasive axial presacral L5-S1 interbody fusion: two-year clinical and radiographic outcomes. Spine. 2011;36(20):E1296–301.

    Article  PubMed  Google Scholar 

  89. Ogilvie JW. Complications in spondylolisthesis surgery. Spine. 2005;30(6 Suppl):S97–101.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Adam S. Kanter MD, FAANS & Michael M. McDowell MD

Authors
  1. Adam S. Kanter MD, FAANS
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael M. McDowell MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Adam S. Kanter MD, FAANS .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery and Orthopaedics, David Geffen UCLA School of Medicine, Los Angeles, California, USA

    Langston T. Holly

  2. Department of Orthopedics and Rehabilitation, University of Wisconsin UWMF, Madison, Wisconsin, USA

    Paul A. Anderson

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Kanter, A.S., McDowell, M.M. (2017). Repair of Pars Defects and Spondylosis. In: Holly, L., Anderson, P. (eds) Essentials of Spinal Stabilization . Springer, Cham. https://doi.org/10.1007/978-3-319-59713-3_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-59713-3_23

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-59712-6

  • Online ISBN: 978-3-319-59713-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation