Smiley Rod Technique for Direct Pars Repair in Patients with Symptomatic Lumbar Spondylolysis: A Prospective Case Series
5 affiliations
- 1Department of Orthopedics, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India.
- 2Department of Orthopedics, Central Institute of Orthopedics, VMMC and Safdarjung Hospital, New Delhi, India.
- 3Department of Hand Surgery, Institute for Research and Rehabilitation of Hand and DPH, Government Stanley Medical College, Chennai, Tamil Nadu, India.
- 4Department of Orthopedics Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
- 5Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Abstract
Introduction: Lumbar spondylolysis is a common cause of chronic low back pain in adolescents and young adults. Although most patients improve with conservative treatment, persistent symptoms may require surgery. Fusion provides stability but sacrifices segmental motion. Direct pars repair aims to restore pars continuity while preserving mobility. This study evaluated clinical and radiological outcomes of the Smiley Rod technique for symptomatic L5 spondylolysis. Materials and Methods: This prospective case series included ten patients aged 18–40 years with symptomatic L5 pars defects who failed at least 6 months of conservative management. Patients with Grade II or higher spondylolisthesis, significant disc degeneration, spinal canal stenosis, infection, or previous lumbar surgery were excluded. All patients underwent direct pars repair using the Smiley Rod technique. Visual Analog Scale (VAS) and Oswestry disability Index (ODI) scores were recorded preoperatively and at 3 months, 6 months, and 1 year. Computed tomography was used to assess pars fusion at 1 year. Result: The mean pre-operative VAS score improved from 6.1 ± 0.7 to 1.3 ± 0.4 at 1 year. Mean ODI improved from 58.4% ± 6.2% preoperatively to 14.8% ± 3.6% at final follow-up. Complete pars fusion was seen in six patients and partial fusion in four. All patients returned to routine activities within 6 months. No implant-related complications, neurological deficits, surgical site infections, or adjacent segment degeneration were observed. Conclusion: The smiley rod technique appears to be a safe and effective motion-preserving option for selected patients with symptomatic L5 spondylolysis, with favorable short-term clinical and radiological outcomes.
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BibTeX
@article{panda2026smiley,
title = {{Smiley Rod Technique for Direct Pars Repair in Patients with Symptomatic Lumbar Spondylolysis: A Prospective Case Series}},
author = {Aditya Prasad Panda and Priyankar Nanda and Sudipta Kumar Patra and Anuraag Mohanty and Saptarshi Bajpai and Geeta Chand Acharya},
journal = {Journal of Orthopaedic Case Reports},
year = {2026},
month = nov,
doi = {10.13107/jocr.2026.v16.i11.8496},
url = {https://doi.org/10.13107/jocr.2026.v16.i11.8496},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Smiley Rod Technique for Direct Pars Repair in Patients with Symptomatic Lumbar Spondylolysis: A Prospective Case Series
AU - Aditya Prasad Panda
AU - Priyankar Nanda
AU - Sudipta Kumar Patra
AU - Anuraag Mohanty
AU - Saptarshi Bajpai
AU - Geeta Chand Acharya
PY - 2026
DA - 2026/11/01
JO - Journal of Orthopaedic Case Reports
DO - 10.13107/jocr.2026.v16.i11.8496
UR - https://doi.org/10.13107/jocr.2026.v16.i11.8496
AB - Introduction: Lumbar spondylolysis is a common cause of chronic low back pain in adolescents and young adults. Although most patients improve with conservative treatment, persistent symptoms may require surgery. Fusion provides stability but sacrifices segmental motion. Direct pars repair aims to restore pars continuity while preserving mobility. This study evaluated clinical and radiological outcomes of the Smiley Rod technique for symptomatic L5 spondylolysis. Materials and Methods: This prospective case series included ten patients aged 18–40 years with symptomatic L5 pars defects who failed at least 6 months of conservative management. Patients with Grade II or higher spondylolisthesis, significant disc degeneration, spinal canal stenosis, infection, or previous lumbar surgery were excluded. All patients underwent direct pars repair using the Smiley Rod technique. Visual Analog Scale (VAS) and Oswestry disability Index (ODI) scores were recorded preoperatively and at 3 months, 6 months, and 1 year. Computed tomography was used to assess pars fusion at 1 year. Result: The mean pre-operative VAS score improved from 6.1 ± 0.7 to 1.3 ± 0.4 at 1 year. Mean ODI improved from 58.4% ± 6.2% preoperatively to 14.8% ± 3.6% at final follow-up. Complete pars fusion was seen in six patients and partial fusion in four. All patients returned to routine activities within 6 months. No implant-related complications, neurological deficits, surgical site infections, or adjacent segment degeneration were observed. Conclusion: The smiley rod technique appears to be a safe and effective motion-preserving option for selected patients with symptomatic L5 spondylolysis, with favorable short-term clinical and radiological outcomes.
SN - 2250-0685
SN - 2321-3817
ER -