Direct Pars Repair (Buck's Screw)
A fractured pars defect is directly repaired using a small screw and bone graft — preserving spinal motion in young patients with isolated spondylolysis instead of jumping to fusion.
What is Direct Pars Repair (Buck's Screw)?
Direct Pars Repair, often called Buck's Screw fixation, is a motion-preserving surgical technique used to treat isolated symptomatic spondylolysis — a stress-related defect of the pars interarticularis without significant vertebral slip. Through a small posterior approach, the fibrous tissue at the defect is removed, the bone is freshened, and a small precisely directed compression screw is inserted across the defect with local bone graft to promote biological healing. The vertebral motion segment is preserved entirely, sparing the patient the long-term consequences of fusion. Dr. Hithesh performs Buck's screw repair in Hyderabad for carefully selected younger patients seeking to preserve their natural spinal motion.
How the Procedure Works
Anaesthesia & Positioning
General anaesthesia is delivered; the patient is positioned prone on a Wilson frame, allowing safe access to the lumbar pars defect.
Targeted Incision
A small midline posterior incision exposes the lumbar paraspinal muscles, which are reflected to expose the affected pars interarticularis defect.
Defect Preparation
Fibrous tissue at the defect is removed using a curette; the bony surfaces are freshened and prepared for bone grafting and fusion.
Bone Graft & Screw Fixation
Local autograft is packed into the defect; a precisely directed compression screw is inserted across the defect, securing fragments under compression.
Closure & Recovery
Soft tissue layers are closed; bracing supports the spine during early healing; gradual return to activity follows under careful clinical guidance.
Outcomes
Who Needs This Treatment?
- →Preserves natural spinal motion segment, avoiding the long-term consequences of fusion
- →Targeted procedure with smaller incision than fusion surgery
- →Excellent option for younger active patients with isolated symptomatic spondylolysis
- →Reliable bone healing of the pars defect in well-selected suitable cases
- →Allows safe return to active recreational and competitive sport afterwards
- →Bone graft and compression screw provide reliable biological healing environment
When a young athlete has isolated spondylolysis without slip, fusing them is using a sledgehammer to crack a nut. Buck's screw repair heals the defect, preserves their spine and gets them back to sport.
— — Dr. Bathini Hithesh, Consultant Orthopaedic Surgeon, Trauma & Joint Replacement Specialist, Lux Hospitals, Hyderabad
Common Questions
Frequently Asked Questions
Not sure which treatment is right for you?
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