2020 Volume 11 Issue 8 Pages 1061-1067
Introduction: Pars defects repair is effective for end-stage lumbar spondylolysis in which pain remains even after conservative therapy. We avoided interbody fusion which causes adjacent intervertebral disorders and selected pars defects repair because of preservation lumbar mobile segments. Modified Smiley Face Rod method was applied to two judo players with lumbar spondylolysis with pseudoarthrosis. In both cased, bony fusion was achieved, and it was possible to return to the competition without compromising performance.
Cases: Case 1 was 14-year-old male Judo player with black belt. At the first consultation, a lumbar spondylolysis with slip of grade 1 in the Meyerding classification was found in the 5th lumbar. Since conservative therapy did not improve pain and was unable to return to the competition, a modified Smiley Face Rod repair procedure was performed 7 months after the start of the treatment. The reduction of the anterior slip of the 5th lumbar vertebra was obtained with the operation. Wearing brace was continued for 3 months after the operation, and judo was resumed 6 months after the operation. He returned to the game 8 months after the operation and participated in the prefectural tournament and achieved a prize. Case 2 was a 14-year-old female with five years of judo history. At the first consultation, a lumbar spondylolysis with slip of grade 1 in the Meyerding classification was found in the 5th lumbar. As conservative treatment with brace and physiotherapy were performed, and back pain improved in 2 months and judo was resumed. However, the pain became severe again, and it became difficult to continue the competition. Therefore, a pars defect repair using a modified Smiley Face Rod method was performed, and reduction of the slip of the 5th lumbar was obtained. She finished wearing the brace 3 months after the operation, resumed judo 4 months after the operation, and returned to the game 11 months after the operation. Bone union was performed partially 12 months after the operation and confirmed absolutely 36 months after the operation.
Conclusion: The modified Smiley Face Rod method was possible to correct slips of grade 1 in the Meyerding classification, and was able to return to Judo without removing implants.
