Name: BreakThrough™ With Christopher Adams, MD—Percutaneous Pars Fracture Repair Episode 5: The Patient Experience
Uploaded: 2026-10-01T10:27:00Z
Channel: Arthrex
Description: In this episode, leading spine surgeons discuss how their patients have benefited from percutaneous pars fracture repair using the fully threaded spine compression screw. Joining host Christopher Adams, MD, are in-studio guests Michael A. Gallizzi, MD (Vail, CO); Raymond J. Gardocki, MD (Nashville, TN); Saqib Hasan, MD (San Francisco, CA); and Christopher A. Yeung, MD (Phoenix, AZ).

Spine

<p>In this episode, leading spine surgeons discuss how their patients have benefited from percutaneous pars fracture repair using the fully threaded spine compression screw. Joining host Christopher Adams, MD, are in-studio guests Michael A. Gallizzi, MD (Vail, CO); Raymond J. Gardocki, MD (Nashville, TN); Saqib Hasan, MD (San Francisco, CA); and Christopher A. Yeung, MD (Phoenix, AZ).</p>

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VID1-009102-en-US | A | BreakThrough™ With Christopher Adams, MD—Percutaneous Pars Fracture Repair Episode 5: The Patient Experience

Christopher Adams

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Michael Gallizzi

Raymond J. Gardocki

Saqib Hasan, MD

Christopher A. Yeung, MD

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BreakThrough™ With Christopher Adams, MD—Percutaneous Pars Fracture Repair Episode 5: The Patient Experience 

Speaker  Welcome to BreakThrough. Today we're going to be discussing fully threaded compression screws for the treatment of pars fractures with Michael Gillies from Vail, Colorado, in Ray Gardocki from Nashville, Tennessee. Now, keep in mind, Saqib Hasan from San Francisco, California, and Chris Young from Phoenix, Arizona, will also be joining us a little bit later. Mike Ray, it's good to have you here with us. Speaker  Very nice to be here. Thanks, Chris. Thanks for having us. Speaker  Absolutely. So Mike, a percutaneous approach utilizing fully threaded compression screws for pars fractures is a novel concept. How are patients benefiting from this groundbreaking treatment? Speaker  You know, I think that's a great question because originally when we sort of started moving to fixing this, it was an open surgery and that was the traditional approach. And you would just use standard screws. But now we're able to do this percutaneously small incisions, preserving the natural anatomy, the muscle, the ligaments. And with the compression screw technology, we're able to actually compress across that fracture. So in these patients, the younger ones we treat that are adolescent athletes, even into some semi-professional and professional athletes. What we're able to do is fix the actual fracture to get them back, to return to play a little bit sooner and return their anatomic function and prevent what we don't want to have happen, which is a spondylolisthesis or an anterior shift of the spine, which typically will then lead on to a possible fusion. Speaker  That's really remarkable. Now, Ray, how do you decide which patients would benefit from a conservative treatment approach versus those that would benefit more from early surgical intervention? Speaker  Well, Chris, like most things, it depends on patient specific factors. So things like the patient's age stage of the disease process and activity level. But we really do owe a duty of conservative treatment to all these patients. So if you have a patient who has failed 6 to 12 weeks of conservative treatment and are still symptomatic, especially if they have a documented defect or gap on the pars, doing a percutaneous pars fixation is a great option, even in the most ideal situation where you have edema in the pedicle, no disc degeneration and no listhesis. Conservative treatment leaves upwards of 30% non-union, so with fixation of these, you can gain an anatomic reduction and fix the fracture and prevent the future risk of spondylolisthesis. Speaker  Thanks, Ray. And Mike, that was truly wonderful. Now let's bring in Chris Young and Saqib Hasan. Thanks for joining us guys. Thanks, Chris. Chris, let's start with you. What does the treatment timeline look like for these patients and is there extensive rehab following surgery? Speaker  Yeah. So typically I mean this is a fracture. So initially we want early protection. I always treat my patients with a LSO brace for six weeks at about 2 to 3 weeks post op. We'll start them in some neutral spine trunk stabilization not doing any flexion extension. After six weeks they can then progress based on their symptoms and how strong their trunk is. And typically earliest return to play is about 12 weeks, give or take a few weeks, depending on if it's acute or a chronic fracture. And then we can verify fracture healing at about 3 to 6 months with a CT scan. Speaker  Okay. That's great. Thank you for that overview, Chris. Now, we've mentioned that pars fractures are common in young active adults. But as a parent, any time your child has recommended surgery, it can be very scary. So Saqib, how do you navigate that surgical discussion with parents? Well, you know. Speaker  Surgery in general can be very anxiety provoking and very, very scary. So I understand the hesitation, but I like to frame it in terms of dosing and spine surgery because as a surgeon, our goal is to provide the most effective treatment option with the least amount of risk. By leveraging technologies, we can really minimize that risk and provide a more palatable option for families. Speaker  That makes perfect sense. That's a great insight. Now, before we close, can each of you leave us with your final thoughts on how the percutaneous technique with fully threaded compression screws has changed your practice and the patient experience? Speaker  Yeah. Chris. So this has changed my practice tremendously. Early in my career, I didn't offer surgical treatment for any of these patients. But now seeing the impressive results, I certainly advocate for surgery for my patients. And I even advocate for earlier surgery when they have an acute fracture and not, like the literature says, waiting for six months of failed non-operative treatment. Speaker  Makes perfect sense. Speaker  I think it conceptually changes how I look at this patient population. I think in general, times change and so do patients expectations. So I think this is another example of me just leveraging a technology that allows me to really meet my patients where they are and elevate the standard of care. Speaker  Oh, absolutely. So gentlemen, thank you for sharing your insights focused on the patient experience. I think we've all learned that we've entered a new era in treating pars fractures, one that prioritizes not only clinical success but also personalized, patient centered care. Now, to learn more about fully threaded compression screws for the treatment of pars fractures, be sure to tune in to our other breakthrough episodes, including Innovative solutions, technique, play by play making the case, and lessons learned. Thank you for joining us.

BreakThrough™ With Christopher Adams, MD—Percutaneous Pars Fracture Repair Episode 5: The Patient Experience

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