Repair of spondylolytic defect with a cable screw reconstruction.

We present the clinical and radiological results of surgical repair for refractory spondylolysis in 20 patients at a minimum follow-up of 2 years. Seventeen of them were reassessed after 5 years. The Oswestry scores revealed good to excellent results in 90% (18/20 patients), indicating a good outcome with surgical repair using two techniques: the Scott procedure or pedicle screw and wire technique. Radiological pseudarthosis was 10%, which was quite consistent with reported series. CT scanning of the 14 patients after a mean of 13 months revealed complete healing of the fracture in 7 patients, partial in 2 and frank non-union in 5. Overall, CT examination with reversed gantry showed only 7/14 (50%) healing, indicating that radiological healing on plain X-ray is not always suggestive of complete bony healing. However, CT healing is not a sine qua non of good to excellent clinical outcome.