• Lester Wilson, Farhaan Altaf, and Philippa Tyler.
• Royal National Orthopaedic Hospital, Stanmore, London, UK.
• Eur Spine J. 2016 Jun 1; 25 (6): 1651-4.

PurposeA conventional midline posterior approach is used for most of the described surgical techniques. We describe a technique of percutaneous fixation of the pars interarticularis, augmented where necessary by grafting the defect, which minimises muscle injury.MethodA 4.5 mm partially threaded dynamic compression screw is placed over a wire inserted percutaneously across the pars interarticularis defect. Compression is achieved across the pars interarticularis defect on placement of the screw. The screw is locked in a compressed state.ResultsThe patient is mobilised the same day with a corset for comfort and discharged the following day. Aerobic fitness is maintained for 3 months; then, focused rehabilitation performed until a CT scan confirms healing at 5-6 months, at which stage full (sports) activity is resumed.ConclusionsThe minimal tissue injury and small incision used allow for the minimising of complications and for a rapid recovery and discharge from hospital. With adolescents, we have the opportunity to treat symptomatic pars interarticularis defects with minimal disruption to their academic and physical development.

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