ABSTRACT
Lumbar spondylolysis is considered to be a stress fracture of the pars interarticularis (1-3), which occurs in approximately 6% of the entire population (4,5). This disorder is usually clinically benign (4); however, in certain cases, surgical treatment is required to reduce the symptoms. For surgical treatment of lumbar spondylolysis, various techniques reported in the literature can be grouped into three categories: direct repair of the lysis, lumbar intersegmental fusion, and decompression. Direct repair of spondylolysis has been widely used to treat young patients in which severe disc degeneration and instability are not apparently combined (1,6,7). When severe disc degeneration causing low back pain and/or instability are observed, lumbar intersegmental fusion has been performed (8,9). Gill et al. (10) were the first to describe nonfusion decompressive surgery in patients with radiculopathy as a result of lumbar spondylolysis. The short-term clinical results were reported to be good. However, some authors have reported that the Gill’s laminectomy result in further vertebral slippage postoperatively (11-14); therefore, some surgeons have recommended decompression with simultaneous spinal fusion. If there is a minimally invasive decompression surgery that does not alter the lumbar biomechanics after surgery further additional spinal fusion may not be necessary. Based on this concept, we developed minimally invasive decompression of nerve root affected by lumbar spondylolysis using a spinal endoscope. The spinal endoscope for the posterior decompression surgery was first established by Foley and Smith (15) as a technique for discectomy, and currently, this technique has been widely applied to other spinal disorders (16-21).
