{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:51:13Z","timestamp":1787755873357,"version":"build-2784847793"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 14-year-old national-level badminton player presented with bilateral L5 pars interarticularis defects with pseudoarthrosis, unresponsive to conservative management. Computed tomography confirmed bilateral pars defect with sclerosed margins without spondylolisthesis or canal compromise. The patient underwent robotic-assisted minimally invasive pars repair augmented with recombinant human bone morphogenetic protein. Postoperatively, he reported minimal pain, resumed full athletic training by 12 weeks, and remained symptom-free at 1-year follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Robotic-assisted direct pars repair with biologic augmentation offers precise screw placement, muscle preservation, and accelerated recovery in adolescent spondylolysis, representing a valuable option for patients failing conservative therapy and seeking rapid return to sport.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.25.00257","type":"journal-article","created":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T18:01:14Z","timestamp":1756404074000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Precision Repair of Bilateral Pars Defect Using Robotic Assistance and r-Bmp in a National-Level Adolescent Athlete"],"prefix":"10.2106","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6043-006X","authenticated-orcid":false,"given":"Shanmuganathan","family":"Rajasekaran","sequence":"first","affiliation":[{"name":"Department of Spine Surgery, Ganga Hospital, Coimbatore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4935-0778","authenticated-orcid":false,"given":"Harikrishna","family":"Raghuraj Ramasamy","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Ganga Hospital, Coimbatore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8885-5411","authenticated-orcid":false,"given":"K.S.","family":"Sri Vijay Anand","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Ganga Hospital, Coimbatore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5817-4909","authenticated-orcid":false,"given":"Rishi Mugesh","family":"Kanna","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Ganga Hospital, Coimbatore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5885-7152","authenticated-orcid":false,"given":"Ajoy Prasad","family":"Shetty","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Ganga Hospital, Coimbatore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,7]]},"reference":[{"issue":"2","key":"bib1-20250828","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1007\/s00381-012-1942-2","article-title":"L5 spondylolysis\/spondylolisthesis: a comprehensive review with an anatomic focus","volume":"29","author":"Foreman","year":"2013","journal-title":"Childs Nerv Syst."},{"issue":"10","key":"bib2-20250828","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1097\/01.BRS.0000061992.98108.A0","article-title":"The natural history of spondylolysis and spondylolisthesis: 45-Year follow-up evaluation","volume":"28","author":"Beutler","year":"2003","journal-title":"Spine (Phila Pa 1976)."},{"issue":"2","key":"bib3-20250828","doi-asserted-by":"crossref","first-page":"299","DOI":"10.3171\/2022.1.SPINE211345","article-title":"Robot-assisted and augmented reality-assisted spinal instrumentation: a systematic review and meta-analysis of screw accuracy and outcomes over the last decade","volume":"37","author":"Tovar","year":"2022","journal-title":"J Neurosurg Spine."},{"key":"bib4-20250828","doi-asserted-by":"crossref","first-page":"e745","DOI":"10.1016\/j.wneu.2018.08.157","article-title":"Robot-assisted versus fluoroscopy-assisted cortical bone trajectory screw instrumentation in lumbar spinal surgery: a matched-cohort comparison","volume":"120","author":"Le","year":"2018","journal-title":"World Neurosurg."},{"issue":"7","key":"bib5-20250828","doi-asserted-by":"crossref","first-page":"531","DOI":"10.5312\/wjo.v8.i7.531","article-title":"Use of recombinant human bone morphogenetic protein-2 in spine surgery","volume":"8","author":"Lykissas","year":"2017","journal-title":"World J Orthop."},{"issue":"4","key":"bib6-20250828","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1053\/j.semss.2010.06.011","article-title":"Lumbar spondylolysis and spondylolisthesis in athletes","volume":"22","author":"Watkins","year":"2010","journal-title":"Semin Spine Surg."},{"issue":"5","key":"bib7-20250828","doi-asserted-by":"crossref","first-page":"699","DOI":"10.2106\/00004623-198466050-00008","article-title":"The natural history of spondylolysis and spondylolisthesis","volume":"66","author":"Fredrickson","year":"1984","journal-title":"J Bone Jt Surg Am."},{"issue":"4","key":"bib8-20250828","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1302\/0301-620X.77B4.7615609","article-title":"Lumbar spondylolysis in children and adolescents","volume":"77","author":"Morita","year":"1995","journal-title":"J Bone Joint Surg Br."},{"issue":"9","key":"bib9-20250828","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1097\/01.brs.0000260978.10073.90","article-title":"Clinical outcome of symptomatic unilateral stress injuries of the lumbar pars interarticularis","volume":"32","author":"Debnath","year":"2007","journal-title":"Spine (Phila Pa 1976)."},{"issue":"10","key":"bib10-20250828","doi-asserted-by":"crossref","first-page":"1628","DOI":"10.1016\/j.spinee.2022.04.011","article-title":"Management of lumbar spondylolysis in the adolescent athlete: a review of over 200 cases","volume":"22","author":"Choi","year":"2022","journal-title":"Spine J."},{"issue":"3","key":"bib11-20250828","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1302\/0301-620X.52B3.432","article-title":"Direct repair of the defect in spondylolisthesis","volume":"52-B","author":"Buck","year":"1970","journal-title":"J Bone Joint Surg Br."},{"issue":"1","key":"bib12-20250828","doi-asserted-by":"crossref","first-page":"E10","DOI":"10.3171\/2017.11.FOCUS17581","article-title":"A comparison of the techniques of direct pars interarticularis repairs for spondylolysis and low-grade spondylolisthesis: a meta-analysis","volume":"44","author":"Mohammed","year":"2018","journal-title":"Neurosurg Focus."},{"issue":"3","key":"bib13-20250828","first-page":"265","article-title":"Does direct surgical repair benefit pars interarticularis fracture? A systematic review and meta-analysis","volume":"25","author":"Tsai","year":"2022","journal-title":"Pain Physician."},{"issue":"2","key":"bib15-20250828","doi-asserted-by":"crossref","first-page":"136","DOI":"10.4103\/0019-5413.77133","article-title":"Direct repair of lumbar spondylolysis by Buck's technique","volume":"45","author":"Rajasekaran","year":"2011","journal-title":"Indian J Orthop."},{"issue":"2","key":"bib16-20250828","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1302\/0301-620X.85B2.13074","article-title":"Clinical outcome and return to sport after the surgical treatment of spondylolysis in young athletes","volume":"85","author":"Debnath","year":"2003","journal-title":"J Bone Joint Surg Br."},{"issue":"4","key":"bib17-20250828","first-page":"899","article-title":"Robotic vs. freehand pedicle screw accuracy in pediatric scoliosis: a multicenter study","volume":"11","author":"Li","year":"2023","journal-title":"Spine Deform."},{"issue":"5","key":"bib18-20250828","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1007\/s43390-024-00879-y","article-title":"Robot-assisted pedicle screw insertion versus navigation-based and freehand techniques for posterior spinal fusion in scoliosis: a systematic review and meta-analysis","volume":"12","author":"Al-Naseem","year":"2024","journal-title":"Spine Deform."},{"key":"bib19-20250828","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.clineuro.2015.08.024","article-title":"A minimally invasive approach to defects of the pars interarticularis: restoring function in competitive athletes","volume":"139","author":"Gillis","year":"2015","journal-title":"Clin Neurol Neurosurg."},{"issue":"3","key":"bib20-20250828","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1177\/15563316241234843","article-title":"Return to sports following spondylolysis surgery in children and adolescents: a systematic review","volume":"20","author":"Gross","year":"2024","journal-title":"HSS J."},{"key":"bib21-20250828","first-page":"9","article-title":"Robotic-assisted spine surgery: history, efficacy, cost, and future trends","volume":"6","author":"D'Souza","year":"2019","journal-title":"Robotic Surg (Auckland)."},{"issue":"18","key":"bib22-20250828","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1097\/BRS.0000000000004381","article-title":"Robotics reduces radiation exposure in minimally invasive lumbar fusion compared with navigation","volume":"47","author":"Shahi","year":"2022","journal-title":"Spine (Phila Pa 1976)."},{"issue":"3","key":"bib23-20250828","doi-asserted-by":"crossref","first-page":"216","DOI":"10.14245\/ns.1836082.041","article-title":"A cost-effectiveness analysis of the integration of robotic spine technology in spine surgery","volume":"15","author":"Menger","year":"2018","journal-title":"Neurospine."},{"issue":"13","key":"bib24-20250828","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1097\/BRS.0b013e3182880298","article-title":"Transforaminal lumbar interbody fusion with rhBMP-2 in spinal deformity, spondylolisthesis, and degenerative disease--part 2: BMP dosage-related complications and long-term outcomes in 509 patients","volume":"38","author":"Crandall","year":"2013","journal-title":"Spine (Phila Pa 1976)."},{"issue":"3","key":"bib25-20250828","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/j.spinee.2017.08.230","article-title":"Comparison of transforaminal lumbar interbody fusion outcomes in patients receiving rhBMP-2 versus autograft","volume":"18","author":"Khan","year":"2018","journal-title":"Spine J."},{"issue":"14","key":"bib26-20250828","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1097\/BRS.0000000000000971","article-title":"A systematic review of lumbar fusion rates with and without the use of rhBMP-2","volume":"40","author":"Galimberti","year":"2015","journal-title":"Spine (Phila Pa 1976)."},{"issue":"1","key":"bib27-20250828","doi-asserted-by":"crossref","first-page":"19","DOI":"10.3171\/spi.2004.1.1.0019","article-title":"Contribution of recombinant human bone morphogenetic protein-2 to the rapid creation of interbody fusion when used in transforaminal lumbar interbody fusion: a preliminary report. Invited submission from the joint section meeting on disorders of the spine and peripheral nerves, march 2004","volume":"1","author":"Mummaneni","year":"2004","journal-title":"J Neurosurg Spine."},{"issue":"1","key":"bib28-20250828","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1097\/BRS.0000000000000043","article-title":"Clinical results and functional outcomes after direct intralaminar screw repair of spondylolysis","volume":"39","author":"Menga","year":"2014","journal-title":"Spine."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.25.00257","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:53:19Z","timestamp":1787752399000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.25.00257"}},"subtitle":["A Case Report"],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":27,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.25.00257","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]}}}