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Review article
DOI: 10.1016/j.neucir.2017.07.008
Headless compression screw in the neuronavigation-guided and microscope-assisted treatment of spondylolysis
Tornillo de compresión sin cabeza en el tratamiento de la espondilolisis guiada por neuronavegación y asistida por microscopio
Francisco Javier Goncalves-Ramíreza,
Corresponding author
ncrfranc@gmail.com

Corresponding author.
, Manel Tardaguila Serranoa, Sherman H. Leeb, Carlos Javier Domingueza, Jordi Manuel-Rimbaua
a Departamento de Neurocirugía, Hospital Germans Trias i Pujol, Badalona, Spain
b Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
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Abstract

Since 1968, many surgical techniques used in repairing the pars defect of the vertebra have been reported. Technological advances are giving rise to new ways of obtaining the best outcome using less invasive methods, which are more accurate, simple and effective. To treat cases of spondylolysis such as pseudarthrosis, we used neuro-navigation and microscopy through a 2.5-cm skin incision to approach the pars defect, freshen the fracture and place a type of screw that, until now, has never been used for this purpose. This is a novel technique, which guarantees prolonged compression and sufficient stability to facilitate the prompt healing of the vertebra. We present 2 cases of L5 spondylolysis treated with our technique, a modification of Buck's technique. A detailed description of the screw selection, surgical technical details, follow-up and outcome are discussed.

Keywords:
Buck's technique
Minimally invasive spinal surgery
Headless compression screw
Spondylolysis
Neuronavigation
Resumen

Desde 1968 se han descrito muchas técnicas quirúrgicas utilizadas para reparar el defecto en la pars de la vértebra. Los avances tecnológicos están dando lugar a nuevas formas de obtener el mejor resultado utilizando métodos menos invasivos que son más precisos, simples y eficaces. Para tratar los casos de espondilolisis como una unión en seudoartrosis, se utilizó la neuronavegación y la microscopía a través de una incisión cutánea de 2,5cm para abordar el defecto de la pars, refrescar la fractura y colocar un tipo de tornillo que no se ha utilizado previamente con ese fin. Esta es una técnica novedosa, que garantiza una compresión prolongada y suficiente estabilidad para lograr la curación oportuna de la vértebra. Presentamos 2 casos de espondilolisis de L5 tratados con nuestra técnica, una modificación de la técnica de Buck. Se realiza una descripción detallada de la selección del tornillo, detalles técnicos quirúrgicos, seguimiento y resultado.

Palabras clave:
Técnica de Buck
Cirugía espinal minimamente invasiva
Tornillo de compresión sin cabeza
Espondilolisis
Neuronavegación

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