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.
Reserved for younger patients under 30 with confirmed isolated symptomatic spondylolysis without significant vertebral slip or disc degeneration — particularly active individuals seeking to preserve spinal motion and avoid fusion.
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?
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Preserves natural spinal motion segment, avoiding the long-term consequences of fusion
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Targeted procedure with smaller incision than fusion surgery
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Excellent option for younger active patients with isolated symptomatic spondylolysis
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Reliable bone healing of the pars defect in well-selected suitable cases
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Allows safe return to active recreational and competitive sport afterwards
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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
Direct Pars Repair (Buck's Screw) Cost in Hyderabad
The cost of direct pars repair using Buck's screw in Hyderabad depends on the extent of the pars defect, the condition of the vertebra, the complexity of the procedure, implant requirements, investigations required, and the care needed before and after surgery.
For young patients with an isolated pars defect, the approximate cost of direct pars repair ranges between ₹2,00,000 and ₹3,50,000.
| Procedure | Approximate Cost Range |
|---|---|
| Direct Pars Repair (Buck's Screw) | ₹2,00,000 – ₹3,50,000 |
The final cost may vary depending on your individual condition, findings during evaluation, type of fixation used, and whether any additional procedures are required.
Factors That Influence Direct Pars Repair Cost
The overall cost may depend on:
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Extent of pars defect: The location and severity of the defect, spinal stability, vertebral condition, and associated changes may influence treatment planning and surgical complexity.
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Pre-operative evaluation: Required investigations, clinical examination, X-rays, MRI scans, CT scans, and medical assessments before surgery may affect the overall cost.
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Implant and additional procedure requirements: The type and number of screws, fixation components, bone graft materials, and any additional spinal procedures required may influence the cost.
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Hospital stay and post-operative care: The duration of admission, medicines, physiotherapy, rehabilitation, and follow-up requirements may influence the final estimate.
Is Direct Pars Repair Covered by Insurance?
Direct pars repair may be covered by health insurance when it is performed for a medically necessary spinal condition. Coverage depends on your insurance policy, inclusions, and approval process.
Our insurance support team can assist you with checking your policy coverage, required documentation, the cashless approval process, and insurance-related queries before the procedure.
- Checking your policy coverage
- Cashless approval process
- Required documentation
- Insurance-related queries before the procedure
Dr. Hitesh Bathini
Orthopaedic Surgeon
During consultation, Dr. Hitesh Bathini, Orthopaedic Surgeon in Hyderabad, will evaluate your symptoms, medical history, and investigation reports to determine whether direct pars repair is suitable for you. He will explain the procedure, expected outcomes, and guide you regarding the estimated cost based on your individual condition and treatment requirements.
Common Questions
Frequently Asked Questions
Not sure which treatment is right for you?
Book a consultation with Dr. Bathini Hithesh and get a personalised treatment plan.