{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T02:22:59Z","timestamp":1790043779222,"version":"4.0.1"},"reference-count":46,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,9]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Although the mainstay of treatment for lumbar spondylolysis is nonoperative management with activity modification, a sizeable portion of patients will go on to nonunion. The growing use of robotic surgical guidance can allow for placement of pars screws through percutaneous incisions. The objective of this case series was to report on the largest series of adolescent patients with lumbar spondylolysis treated with robot-assisted pars repair to date.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A retrospective review of a prospectively collected database was performed for all adolescent patients (aged 13\u201325 years) who underwent pars repairs for treatment of spondylolysis with a single-screw technique. Patient demographic, surgical, and postoperative course information was collected and reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Nine patients who underwent robotic pars repair were identified. The mean \u00b1 SD duration of activity cessation at initial surgical consultation was 8.6 \u00b1 10.6 months. Seven patients underwent bilateral pars repairs and 2 underwent unilateral pars repairs. With a mean \u00b1 SD follow-up of 11.4 \u00b1 9.1 months, 78% of patients had either returned to their baseline activity or were cleared for return to sport at the time of final follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>For patients who fail nonoperative management, robot-assisted pars repair can be a safe and effective treatment option to allow return to activity in as little as 8 weeks. A single screw placed in a lag-by-technique fashion may be as clinically efficacious as open debridement and bone grafting described in prior literature.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.8.spine25688","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T12:00:16Z","timestamp":1769083216000},"page":"349-354","source":"Crossref","is-referenced-by-count":2,"title":["Utilization of robotic pars repair for early return to activity in adolescents with symptomatic spondylolysis: a case series"],"prefix":"10.3171","volume":"44","author":[{"given":"Austin C.","family":"Kaidi","sequence":"first","affiliation":[{"name":"Department of Spine Surgery, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle A.","family":"Zabat","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy L.","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adin","family":"Ehrlich","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyuki","family":"Asada","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harvinder S.","family":"Sandhu","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russel C.","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sravisht","family":"Iyer","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheeraz A.","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"Phys Med Rehabil Clin N Am","first-page":"785","article-title":"Spondylolysis","volume":"11","author":"Standaert CJ","year":"2000","unstructured":"Standaert CJ, Herring SA, Halpern B, King O. Spondylolysis. Phys Med Rehabil Clin N Am. 2000;11(4):785\u2013803."},{"issue":"3","key":"b2","series-title":"Clin Sports Med","first-page":"471","article-title":"Lumbosacral spondylolysis and spondylolisthesis","volume":"40","author":"Chung CC","year":"2021","unstructured":"Chung CC, Shimer AL. Lumbosacral spondylolysis and spondylolisthesis. Clin Sports Med. 2021;40(3):471\u2013490."},{"key":"b3","series-title":"Instr Course Lect","first-page":"431","article-title":"Spondylolisthesis and spondylolysis","volume":"57","author":"Hu SS","year":"2008","unstructured":"Hu SS, Tribus CB, Diab M, Ghanayem AJ. Spondylolisthesis and spondylolysis. Instr Course Lect. 2008;57:431\u2013445."},{"issue":"7","key":"b4","series-title":"J Am Acad Orthop Surg","first-page":"417","article-title":"Spondylolysis and spondylolisthesis in children and adolescents: I. Diagnosis, natural history, and nonsurgical management","volume":"14","author":"Cavalier R","year":"2006","unstructured":"Cavalier R, Herman MJ, Cheung EV, Pizzutillo PD. Spondylolysis and spondylolisthesis in children and adolescents: I. Diagnosis, natural history, and nonsurgical management. J Am Acad Orthop Surg. 2006;14(7):417\u2013424."},{"issue":"7","key":"b5","series-title":"Clin Spine Surg","first-page":"247","article-title":"The management of acute lumbar stress reactions of the pedicle and pars in professional athletes playing collision sports","volume":"34","author":"Vaccaro AR","year":"2021","unstructured":"Vaccaro AR, Divi SN, Kepler CK,  The management of acute lumbar stress reactions of the pedicle and pars in professional athletes playing collision sports. Clin Spine Surg. 2021;34(7):247\u2013259."},{"issue":"1","key":"b6","series-title":"Am J Sports Med","first-page":"57","article-title":"The prevalence of spondylolysis in the Spanish elite athlete","volume":"28","author":"Soler T","year":"2000","unstructured":"Soler T, Calder\u00f3n C. The prevalence of spondylolysis in the Spanish elite athlete. Am J Sports Med. 2000;28(1):57\u201362."},{"key":"b7","series-title":"J Sports Med Phys Fitness","first-page":"450","article-title":"Lumbar spondylolysis: occurrence in competitive athletes. Updated achievements in a series of 390 cases","volume":"30","author":"Rossi F","year":"1990","unstructured":"Rossi F, Dragoni S. Lumbar spondylolysis: occurrence in competitive athletes. Updated achievements in a series of 390 cases. J Sports Med Phys Fitness. 1990;30:450\u2013452."},{"issue":"6","key":"b8","series-title":"Asian Spine J","first-page":"856","article-title":"Lumbar spondylolysis and spondylolytic spondylolisthesis: who should be have surgery? An algorithmic approach","volume":"8","author":"Omidi-Kashani F","year":"2014","unstructured":"Omidi-Kashani F, Ebrahimzadeh MH, Salari S. Lumbar spondylolysis and spondylolytic spondylolisthesis: who should be have surgery? An algorithmic approach. Asian Spine J. 2014;8(6):856\u2013863."},{"issue":"4","key":"b9","series-title":"Sports Med Arthrosc Rev","first-page":"184","article-title":"Review of pediatric spondylolysis and spondylolisthesis","volume":"24","author":"Randall RM","year":"2016","unstructured":"Randall RM, Silverstein M, Goodwin R. Review of pediatric spondylolysis and spondylolisthesis. Sports Med Arthrosc Rev. 2016;24(4):184\u2013187."},{"issue":"17","key":"b10","series-title":"Spine (Phila Pa 1976)","first-page":"1203","article-title":"Correlation of radiographic healing on advanced imaging in young adults and adolescents with symptomatic spondylolysis before and after treatment: a retrospective study","volume":"49","author":"Gauthier C","year":"2024","unstructured":"Gauthier C, Bakaes Y, Puckett H, Dinger J, Giakas A, Horan M. Correlation of radiographic healing on advanced imaging in young adults and adolescents with symptomatic spondylolysis before and after treatment: a retrospective study. 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J Bone Joint Surg Br","first-page":"432","article-title":"Direct repair of the defect in spondylolisthesis","volume":"52","author":"Buck JE","year":"1970","unstructured":"Buck JE. Direct repair of the defect in spondylolisthesis. Preliminary report. J Bone Joint Surg Br. 1970;52(3):432\u2013437."},{"issue":"10","key":"b14","series-title":"Spine (Phila Pa 1976)","first-page":"1027","article-title":"Lytic spondylolysis. Repair by wiring","volume":"11","author":"Nicol RO","year":"1986","unstructured":"Nicol RO, Scott JH. Lytic spondylolysis. Repair by wiring. 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J Bone Joint Surg Am. 1997;79(6):818\u2013825."},{"issue":"3","key":"b17","series-title":"JBJS Rev","first-page":"e21.00176","article-title":"Diagnosis and management of spondylolysis and spondylolisthesis in children","volume":"10","author":"Wu HH","year":"2022","unstructured":"Wu HH, Brown K, Flores M, Cazzulino A, Swarup I. Diagnosis and management of spondylolysis and spondylolisthesis in children. JBJS Rev. 2022;10(3):e21.00176."},{"issue":"2","key":"b18","series-title":"Neurosurg Focus","first-page":"E13","article-title":"Minimally invasive image-guided direct repair of bilateral L-5 pars interarticularis defects","volume":"25","author":"Brennan RP","year":"2008","unstructured":"Brennan RP, Smucker PY, Horn EM. Minimally invasive image-guided direct repair of bilateral L-5 pars interarticularis defects. Neurosurg Focus. 2008;25(2):E13."},{"key":"b19","series-title":"Case Rep Med","first-page":"659078","article-title":"Minimally invasive direct repair of bilateral lumbar spine pars defects in athletes","volume":"2013","author":"Widi GA","year":"2013","unstructured":"Widi GA, Williams SK, Levi AD. Minimally invasive direct repair of bilateral lumbar spine pars defects in athletes. Case Rep Med. 2013;2013:659078."},{"key":"b20","series-title":"Clin Neurol Neurosurg","first-page":"29","article-title":"A minimally invasive approach to defects of the pars interarticularis: restoring function in competitive athletes","volume":"139","author":"Gillis CC","year":"2015","unstructured":"Gillis CC, Eichholz K, Thoman WJ, Fessler RG. A minimally invasive approach to defects of the pars interarticularis: restoring function in competitive athletes. Clin Neurol Neurosurg. 2015;139:29\u201334."},{"issue":"2","key":"b21","series-title":"Neurosurg Focus","first-page":"E6","article-title":"Minimally invasive direct pars repair with cannulated screws and recombinant human bone morphogenetic protein: case series and review of the literature","volume":"43","author":"Ghobrial GM","year":"2017","unstructured":"Ghobrial GM, Crandall KM, Lau A, Williams SK, Levi AD. Minimally invasive direct pars repair with cannulated screws and recombinant human bone morphogenetic protein: case series and review of the literature. Neurosurg Focus. 2017;43(2):E6."},{"key":"b22","series-title":"World Neurosurg","first-page":"181","article-title":"Success and failure of percutaneous minimally invasive direct pars repair: analysis of fracture morphology","volume":"126","author":"Fayed I","year":"2019","unstructured":"Fayed I, Conte AG, Voyadzis JM. Success and failure of percutaneous minimally invasive direct pars repair: analysis of fracture morphology. World Neurosurg. 2019;126:181\u2013188."},{"key":"b23","series-title":"J Neurosurg Case Lessons","first-page":"CASE2415","article-title":"Minimally invasive robot-assisted direct pars repair: illustrative cases","volume":"8","author":"Stewart JJ","year":"2024","unstructured":"Stewart JJ, Zhao DY, Pivazyan G,  Minimally invasive robot-assisted direct pars repair: illustrative cases. J Neurosurg Case Lessons. 2024;8:CASE2415."},{"issue":"4","key":"b1","series-title":"Phys Med Rehabil Clin N Am","first-page":"785","article-title":"Spondylolysis","volume":"11","author":"Standaert CJ","year":"2000","unstructured":"Standaert CJ, Herring SA, Halpern B, King O. Spondylolysis. Phys Med Rehabil Clin N Am. 2000;11(4):785\u2013803."},{"issue":"3","key":"b2","series-title":"Clin Sports Med","first-page":"471","article-title":"Lumbosacral spondylolysis and spondylolisthesis","volume":"40","author":"Chung CC","year":"2021","unstructured":"Chung CC, Shimer AL. Lumbosacral spondylolysis and spondylolisthesis. Clin Sports Med. 2021;40(3):471\u2013490."},{"key":"b3","series-title":"Instr Course Lect","first-page":"431","article-title":"Spondylolisthesis and spondylolysis","volume":"57","author":"Hu SS","year":"2008","unstructured":"Hu SS, Tribus CB, Diab M, Ghanayem AJ. Spondylolisthesis and spondylolysis. Instr Course Lect. 2008;57:431\u2013445."},{"issue":"7","key":"b4","series-title":"J Am Acad Orthop Surg","first-page":"417","article-title":"Spondylolysis and spondylolisthesis in children and adolescents: I. Diagnosis, natural history, and nonsurgical management","volume":"14","author":"Cavalier R","year":"2006","unstructured":"Cavalier R, Herman MJ, Cheung EV, Pizzutillo PD. Spondylolysis and spondylolisthesis in children and adolescents: I. Diagnosis, natural history, and nonsurgical management. J Am Acad Orthop Surg. 2006;14(7):417\u2013424."},{"issue":"7","key":"b5","series-title":"Clin Spine Surg","first-page":"247","article-title":"The management of acute lumbar stress reactions of the pedicle and pars in professional athletes playing collision sports","volume":"34","author":"Vaccaro AR","year":"2021","unstructured":"Vaccaro AR, Divi SN, Kepler CK,  The management of acute lumbar stress reactions of the pedicle and pars in professional athletes playing collision sports. Clin Spine Surg. 2021;34(7):247\u2013259."},{"issue":"1","key":"b6","series-title":"Am J Sports Med","first-page":"57","article-title":"The prevalence of spondylolysis in the Spanish elite athlete","volume":"28","author":"Soler T","year":"2000","unstructured":"Soler T, Calder\u00f3n C. The prevalence of spondylolysis in the Spanish elite athlete. Am J Sports Med. 2000;28(1):57\u201362."},{"key":"b7","series-title":"J Sports Med Phys Fitness","first-page":"450","article-title":"Lumbar spondylolysis: occurrence in competitive athletes. Updated achievements in a series of 390 cases","volume":"30","author":"Rossi F","year":"1990","unstructured":"Rossi F, Dragoni S. Lumbar spondylolysis: occurrence in competitive athletes. Updated achievements in a series of 390 cases. J Sports Med Phys Fitness. 1990;30:450\u2013452."},{"issue":"6","key":"b8","series-title":"Asian Spine J","first-page":"856","article-title":"Lumbar spondylolysis and spondylolytic spondylolisthesis: who should be have surgery? An algorithmic approach","volume":"8","author":"Omidi-Kashani F","year":"2014","unstructured":"Omidi-Kashani F, Ebrahimzadeh MH, Salari S. Lumbar spondylolysis and spondylolytic spondylolisthesis: who should be have surgery? An algorithmic approach. Asian Spine J. 2014;8(6):856\u2013863."},{"issue":"4","key":"b9","series-title":"Sports Med Arthrosc Rev","first-page":"184","article-title":"Review of pediatric spondylolysis and spondylolisthesis","volume":"24","author":"Randall RM","year":"2016","unstructured":"Randall RM, Silverstein M, Goodwin R. Review of pediatric spondylolysis and spondylolisthesis. Sports Med Arthrosc Rev. 2016;24(4):184\u2013187."},{"issue":"17","key":"b10","series-title":"Spine (Phila Pa 1976)","first-page":"1203","article-title":"Correlation of radiographic healing on advanced imaging in young adults and adolescents with symptomatic spondylolysis before and after treatment: a retrospective study","volume":"49","author":"Gauthier C","year":"2024","unstructured":"Gauthier C, Bakaes Y, Puckett H, Dinger J, Giakas A, Horan M. Correlation of radiographic healing on advanced imaging in young adults and adolescents with symptomatic spondylolysis before and after treatment: a retrospective study. Spine (Phila Pa 1976). 2024;49(17):1203\u20131209."},{"issue":"2","key":"b11","series-title":"J Orthop Sci","first-page":"317","article-title":"Union evaluation of lumbar spondylolysis using MRI and CT in adolescents treated conservatively","volume":"27","author":"Tatsumura M","year":"2022","unstructured":"Tatsumura M, Gamada H, Okuwaki S,  Union evaluation of lumbar spondylolysis using MRI and CT in adolescents treated conservatively. J Orthop Sci. 2022;27(2):317\u2013322."},{"issue":"3","key":"b12","series-title":"Clin Sports Med","first-page":"471","article-title":"Lumbosacral spondylolysis and spondylolisthesis","volume":"40","author":"Chung CC","year":"2021","unstructured":"Chung CC, Shimer AL. Lumbosacral spondylolysis and spondylolisthesis. Clin Sports Med. 2021;40(3):471\u2013490."},{"issue":"3","key":"b13","series-title":"Preliminary report. J Bone Joint Surg Br","first-page":"432","article-title":"Direct repair of the defect in spondylolisthesis","volume":"52","author":"Buck JE","year":"1970","unstructured":"Buck JE. Direct repair of the defect in spondylolisthesis. Preliminary report. J Bone Joint Surg Br. 1970;52(3):432\u2013437."},{"issue":"10","key":"b14","series-title":"Spine (Phila Pa 1976)","first-page":"1027","article-title":"Lytic spondylolysis. Repair by wiring","volume":"11","author":"Nicol RO","year":"1986","unstructured":"Nicol RO, Scott JH. Lytic spondylolysis. Repair by wiring. Spine (Phila Pa 1976). 1986;11(10):1027\u20131030."},{"issue":"1","key":"b15","series-title":"Neurosurg Focus","first-page":"E10","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 N","year":"2018","unstructured":"Mohammed N, Patra DP, Narayan V,  A comparison of the techniques of direct pars interarticularis repairs for spondylolysis and low-grade spondylolisthesis: a meta-analysis. Neurosurg Focus. 2018;44(1):E10."},{"issue":"6","key":"b16","series-title":"J Bone Joint Surg Am","first-page":"818","article-title":"Repair of the defect in spondylolysis. Durable fixation with pedicle screws and laminar hooks","volume":"79","author":"Kakiuchi M","year":"1997","unstructured":"Kakiuchi M. Repair of the defect in spondylolysis. Durable fixation with pedicle screws and laminar hooks. J Bone Joint Surg Am. 1997;79(6):818\u2013825."},{"issue":"3","key":"b17","series-title":"JBJS Rev","first-page":"e21.00176","article-title":"Diagnosis and management of spondylolysis and spondylolisthesis in children","volume":"10","author":"Wu HH","year":"2022","unstructured":"Wu HH, Brown K, Flores M, Cazzulino A, Swarup I. Diagnosis and management of spondylolysis and spondylolisthesis in children. JBJS Rev. 2022;10(3):e21.00176."},{"issue":"2","key":"b18","series-title":"Neurosurg Focus","first-page":"E13","article-title":"Minimally invasive image-guided direct repair of bilateral L-5 pars interarticularis defects","volume":"25","author":"Brennan RP","year":"2008","unstructured":"Brennan RP, Smucker PY, Horn EM. Minimally invasive image-guided direct repair of bilateral L-5 pars interarticularis defects. Neurosurg Focus. 2008;25(2):E13."},{"key":"b19","series-title":"Case Rep Med","first-page":"659078","article-title":"Minimally invasive direct repair of bilateral lumbar spine pars defects in athletes","volume":"2013","author":"Widi GA","year":"2013","unstructured":"Widi GA, Williams SK, Levi AD. Minimally invasive direct repair of bilateral lumbar spine pars defects in athletes. Case Rep Med. 2013;2013:659078."},{"key":"b20","series-title":"Clin Neurol Neurosurg","first-page":"29","article-title":"A minimally invasive approach to defects of the pars interarticularis: restoring function in competitive athletes","volume":"139","author":"Gillis CC","year":"2015","unstructured":"Gillis CC, Eichholz K, Thoman WJ, Fessler RG. A minimally invasive approach to defects of the pars interarticularis: restoring function in competitive athletes. 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