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Case Reports in Orthopedics
Volume 2013, Article ID 472968, 6 pages
Case Report

Multilevel Direct Repair Surgery for Three-Level Lumbar Spondylolysis

Department of Orthopedic Surgery, Teikyo University Mizonokuchi Hospital, Kawasaki 213-8507, Japan

Received 20 February 2013; Accepted 7 March 2013

Academic Editors: D. S. Karataglis and I. Madrazo

Copyright © 2013 Tetsu Arai et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


A 45-year-old man presented to our clinic requesting evaluation for surgical treatment of chronic low back pain of more than 20 years duration. He was diagnosed with 3-level lumbar spondylolysis at L3–5. Direct repair using the pedicle screw and hook-rod system was conducted for all three levels. After the surgery, his low back pain completely disappeared. Six months later, he felt discomfort and heard a metallic sound as he twisted his trunk. Computed tomography and radiography indicated that the hook head for L3 and the screw head for L4 were interfering with each other, causing the sound. We confirmed bony union at L3 and removed the L3 system. Surgeons should be aware of such complications if direct repair using a pedicle screw and hook-rod system is conducted for multilevel spondylolysis.