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360 fusion after failed repair of pars defect

Started by RichardT on 05/20/2016 5:10am

I had two good years after successful Buck repair of pars defect but unfortunately the Buck repair eventually failed. See my posts elsewhere under pars defect repair etc. I am a physically active doctor having played rugby for ten years then rowing then regular road cycling and skiing. Developed severe LBP at age 46 and diagnosed with degenerative L5/S1 disc with bilateral pars defect and grade 1 spondylolisthesis. Minimal relief with PT.. Short term relief f rom direct pars block injection. Had direct pars defect/spondylolysis repair using Buck technique of titanium screws across pars with bone auto-graft, This was great for 2 years. Full pain relief, returned to cycling and three x ski trips. Thought it was all fine.

Then after lifting heavy bags up several flights of stairs (oops) had recurrence of LBP as the graft had cracked. To cut a long story short (including failed attempt at revision of Bucks) I ended up in really bad state with severe LBP and severe bilateral foot pain from S1 nerve compression.. So i finally bit the bullet and I have had a 360 fusion at L5/S1. That is 2 stage surgery. First an anterior operation to insert STALIF graft and cage. Then one week later a minimal access PLIF with pedicle screws and rod. Got instant relief after the ALIF as 15mm disc height restored. Now day 3 post second surgery and already walking stairs and going home.

This is much more major surgery but was my only option. Will see how it goes.

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6 weeks post op and the result is amazing.
Abdominal operation was very uncomfortable for a few days and the posteroir minimal access instrumentation (MAS PLIF) was painful weeks 2-6.
The post op X rays are amazing. Normal lordosis restored by the STALIF implant with is a 15 mm wedge shaped implant.
pain improved and back feeling stronger each day.
No regrets for trying the Buck repair but I now realise this is the definitive repair


Hello Richard,
After the bucks repair, had your fracture(s) totally fused?

Be well



I had a good result but with the disc underneath in bad shape I cracked my grafts eventually