Document Type
Article
Publication Date
11-2026
Identifier
DOI: 10.1016/j.jposna.2026.100451; PMCID: PMC13654062
Abstract
Spondylolysis is a common cause of mechanical low back pain in adolescent athletes. While nonoperative management is frequently successful, a subset of patients fail conservative treatment and require surgical intervention. Direct repair of the pars defect offers a motion-preserving alternative to fusion in appropriately selected patients, but traditional open and fluoroscopy-guided minimally invasive techniques are limited by soft-tissue morbidity and variability in screw placement accuracy, and detailed technical descriptions of navigation-assisted approaches remain limited in the literature. We present a detailed, illustrated technique for navigation-assisted minimally invasive direct pars repair, in which a single midline incision accommodates bilateral fixation with minimal soft-tissue disruption. Intraoperative navigation improves trajectory control and reduces reliance on fluoroscopy. This technique offers a reproducible, motion-preserving option for direct pars repair that improves accuracy and reduces surgical morbidity relative to existing approaches, though outcomes remain dependent on careful patient selection and navigation reliability, radiation exposure, and technical familiarity with guidewire and screw placement.
KEY CONCEPTS: (1)Navigation-assisted minimally invasive spine surgery technique allows pars screw placement through indirect visualization.(2)Single midline incision allows bilateral fixation with minimal soft-tissue disruption.(3)Motion-preserving alternative to fusion in appropriately selected patients.(4)Pitfalls include navigation error, inadequate compression across the defect, and poor patient selection (disc degeneration, large defects, or spondylolisthesis).
Journal Title
J Pediatr Soc North Am
Volume
17
First Page
100451
Last Page
100451
PubMed ID
42861160
Keywords
Direct pars repair; Lumbar spondylolysis; Minimally invasive spine surgery; Pars interarticularis; Surgical navigation
Recommended Citation
Mangan J, Schwend R, Anderson J, Benvenuti M, Shaw A. Navigation-Assisted Minimally Invasive Direct Pars Repair for Lumbar Spondylolysis. J Pediatr Soc North Am. 2026;17:100451. Published 2026 Aug 26. doi:10.1016/j.jposna.2026.100451
Comments
This article is available under the Creative Commons CC-BY-NC-ND license and permits non-commercial use of the work as published, without adaptation or alteration provided the work is fully attributed.
Publisher's Link: https://linkinghub.elsevier.com/retrieve/pii/S2768-2765(26)00130-6