This paper describes our experience about isthmic reconstruction on younger children.

Study design: we carried out 9 operations, the average age was 10 and a half, with bilateral spondylolysis at L5 and persistent disabling symptomatology. All had signs of dysplasia in the lumbar spine.

Method: We used the Buck technique.

Results: The follow-up was after 3 years. In all cases we checked if consolidation had occurred without complications. We found all the symptomatology had disappeared and patients were thus free of back pain. We did not find any slippage of vertebra L5 after reconstruction, albeit we have not had a long enough follow-up since the children treated have not yet reached adult status.

Discussion: According to Wiltse there are 5 types of isthmic lysis. Types 1 and 2 are mainly found in young people and are often confused. Type 1 is a dysplasia often found also in type 2 which instead involves isthmic spondylolysis. Therefore we prefer to speak of isthmic dysplastic spondylolysis and isthmic lithic spondylolysis when referring to children.

Conclusions: Is preferable to carry out a reconstruction at an earlier stage to prevent the slippage, as well as the risk of arthrodesis later on.