Proof of work, this was before I added color to the image.
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I can’t edit this to add in my essay, I don’t think posting it was part of the requirements but I’m adding it now anyways.
Pars defect, also known as pars fracture or spondylolysis, is a “unilateral or bilateral
fracture involving the pars interarticularis of the posterior vertebral arch. This injury occurs
almost exclusively in the lower lumbar region, most often at L5” (Mansfield, Wroten, 2023).
This relates to these subjects from class: identify the 4 cells that comprise bone tissue, identify
the 7 functions of bone, compare and contrast the 4 types of bone shapes, know the parts of the
bone and their shape, describe the movement of bones using the proper terminology, and know
the location of bones listed. It will also cover these sections in particular, as they will be most
important and relevant to the subject: explain how bone development is hormonally regulated,
classify fractures, and knowing the stages of bone development and repair. The main cause of
Pars Defect is often unknown, but it is most often attributed to excessive rotation or mechanical
stress (Mansfield, Wroten, 2023).
Pars defect also can have issues healing, as sometimes there is not enough vasculature to
promote bone growth. This means that surgical interventions are often necessary, however,
surgeries for pars defect also present challenges. Most involve fusing two vertebrae together, but
this is only a temporary fix. This is because it shifts the strain and weight up to the disk above
the fused vertebrae, typically within 2-5 years. It will then need to be fused to the vertebrae
above it to reduce the pain. This makes these surgeries not only a temporary fix, but also
expensive because of the need for repeated operations. Most importantly, this has to continue
until nearly all of the back is fused into one bone, making it a very poor optio.
A novel solution to this problem is what is known as the smiley face rod surgery.
According to Okuwaki and colleagues, smiley face rod surgery requires two incisions on either
side of the fractured vertebrae. Each incision is about three to four centimeters in length, making
this a less invasive surgery than other corrective pars defect surgeries. Pedicle screws are placed
in the lateral pedicles of the vertebrae to provide support and hold the U-shaped rod in place
(Tatsumura et al, 2023). To combat the issue of slow healing with pars defect, bone grafts from
the iliac crest of the pelvis are taken and placed in the defect. Afterwards a rod is bent into a “u”
or smiley face shape specifically to match the patients individual anatomy and to preserve the
ligaments and muscles of the spine. The U-shaped rod hooks underneath the spinous process of
the vertebrae inferior to the vertebrae with pedicle screws.
The results of the surgery done on a fourteen-year-old boy are impressive. The young
man had 6.9 mm of slippage in his L5. Through this surgery, the defect was reduced one hundred
percent, and he was able to resume athletics merely eighteen months postoperatively. After six
months, partial bone fusion was noted and by three years, the implant was able to be removed
(Okuwaki et al, 2021). This surgery does not fuse vertebrae together like others do, instead it
promotes the bodies natural healing, which allows patients to return to athletics without the long
term stiffening of the back associated with fusion. All in all, while still a new technique, the
smiley face rod method of surgery is a promising prostpect for those suffering from pars defect.
Nicholas Barnes
Nick Barnes explored the newer technique of fixing Pars defect, also known as spondylosis. Pars defect is “unilateral or bilateral fracture involving the pars interarticularis of the posterior vertebral arch (Mansfield, Wroten, 2023). This typically occurs in the lumbar region of the back. Pars defect causes inadequate vasculature to the affected area which makes healing difficult. The most practiced fix for pars defect is to fuse the affected vertebrae with another vertebra. This was only a temporary fix because this would just put the strain on vertebrae above the fused ones. The newly affected vertebrae would then need to be fused as well, eventually causing the whole spine to be fused together. A newer method called the smiley face rod surgery. This surgery only requires two incisions to be made on either side of the fractured vertebrae. Pedicle screws are placed into the vertebrae in order to support a U-shaped rod that supports the vertebrae. Bone grafts are then placed in the affected area and the rod is bent into a smiley face to match the patient’s vertebrae shape. This surgery method has already been proven to work well in patients with pars defect. This surgery corrected a 6.9 mm slippage in a patient and had them returning to athletics in 18 months. The smiley face rod surgery promotes the bodies natural way of healing, rather than fusing the whole spine together.
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I can’t edit this to add in my essay, I don’t think posting it was part of the requirements but I’m adding it now anyways.
Pars defect, also known as pars fracture or spondylolysis, is a “unilateral or bilateral
fracture involving the pars interarticularis of the posterior vertebral arch. This injury occurs
almost exclusively in the lower lumbar region, most often at L5” (Mansfield, Wroten, 2023).
This relates to these subjects from class: identify the 4 cells that comprise bone tissue, identify
the 7 functions of bone, compare and contrast the 4 types of bone shapes, know the parts of the
bone and their shape, describe the movement of bones using the proper terminology, and know
the location of bones listed. It will also cover these sections in particular, as they will be most
important and relevant to the subject: explain how bone development is hormonally regulated,
classify fractures, and knowing the stages of bone development and repair. The main cause of
Pars Defect is often unknown, but it is most often attributed to excessive rotation or mechanical
stress (Mansfield, Wroten, 2023).
Pars defect also can have issues healing, as sometimes there is not enough vasculature to
promote bone growth. This means that surgical interventions are often necessary, however,
surgeries for pars defect also present challenges. Most involve fusing two vertebrae together, but
this is only a temporary fix. This is because it shifts the strain and weight up to the disk above
the fused vertebrae, typically within 2-5 years. It will then need to be fused to the vertebrae
above it to reduce the pain. This makes these surgeries not only a temporary fix, but also
expensive because of the need for repeated operations. Most importantly, this has to continue
until nearly all of the back is fused into one bone, making it a very poor optio.
A novel solution to this problem is what is known as the smiley face rod surgery.
According to Okuwaki and colleagues, smiley face rod surgery requires two incisions on either
side of the fractured vertebrae. Each incision is about three to four centimeters in length, making
this a less invasive surgery than other corrective pars defect surgeries. Pedicle screws are placed
in the lateral pedicles of the vertebrae to provide support and hold the U-shaped rod in place
(Tatsumura et al, 2023). To combat the issue of slow healing with pars defect, bone grafts from
the iliac crest of the pelvis are taken and placed in the defect. Afterwards a rod is bent into a “u”
or smiley face shape specifically to match the patients individual anatomy and to preserve the
ligaments and muscles of the spine. The U-shaped rod hooks underneath the spinous process of
the vertebrae inferior to the vertebrae with pedicle screws.
The results of the surgery done on a fourteen-year-old boy are impressive. The young
man had 6.9 mm of slippage in his L5. Through this surgery, the defect was reduced one hundred
percent, and he was able to resume athletics merely eighteen months postoperatively. After six
months, partial bone fusion was noted and by three years, the implant was able to be removed
(Okuwaki et al, 2021). This surgery does not fuse vertebrae together like others do, instead it
promotes the bodies natural healing, which allows patients to return to athletics without the long
term stiffening of the back associated with fusion. All in all, while still a new technique, the
smiley face rod method of surgery is a promising prostpect for those suffering from pars defect.
Nick Barnes explored the newer technique of fixing Pars defect, also known as spondylosis. Pars defect is “unilateral or bilateral fracture involving the pars interarticularis of the posterior vertebral arch (Mansfield, Wroten, 2023). This typically occurs in the lumbar region of the back. Pars defect causes inadequate vasculature to the affected area which makes healing difficult. The most practiced fix for pars defect is to fuse the affected vertebrae with another vertebra. This was only a temporary fix because this would just put the strain on vertebrae above the fused ones. The newly affected vertebrae would then need to be fused as well, eventually causing the whole spine to be fused together. A newer method called the smiley face rod surgery. This surgery only requires two incisions to be made on either side of the fractured vertebrae. Pedicle screws are placed into the vertebrae in order to support a U-shaped rod that supports the vertebrae. Bone grafts are then placed in the affected area and the rod is bent into a smiley face to match the patient’s vertebrae shape. This surgery method has already been proven to work well in patients with pars defect. This surgery corrected a 6.9 mm slippage in a patient and had them returning to athletics in 18 months. The smiley face rod surgery promotes the bodies natural way of healing, rather than fusing the whole spine together.