HSS Researchers Report Benefits of Robotic-Assisted Spine Surgery for Adolescent Athletes with Back Pain Due to Pars Fractures

DENVER--(BUSINESS WIRE)--Nov 16, 2025--

Spine surgeons at Hospital for Special Surgery (HSS) reported promising findings for adolescent athletes suffering from pars fracture, a common cause of adolescent back pain that may not always heal on its own and can result in chronic discomfort later in life. Minimally invasive robotic-assisted pars repair enabled most patients to return to sports in as little as six weeks. The findings were reported at the 40th Annual Meeting of the North American Spine Society, held November 14-16 in Denver.

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A pars fracture ­— also called spondylolysis — is a break in the pars interarticularis, a narrow area of bone connecting two vertebrae in the spine. It typically occurs in the lumbar spine (lower back). About 7 percent of all adolescents experience a pars fracture, and that number can rise to as much as 50 percent among teens engaged in high-risk sports such as gymnastics, football, and soccer.

While these injuries can heal on their own after a six- to eight-week break from sports, one in five adolescents continues to experience a non-healing fracture (nonunion). The pain often returns after resuming activity, and some athletes have been told to quit sports entirely. "Nonunion can cause persistent back pain and, in certain cases, even require lumbar fusion later in life if the fracture results in a vertebral slip, where the vertebrae slip out of place," explained Austin Kaidi, MD, an orthopedic surgery resident at HSS and the study's lead author.

About seven years ago, HSS spine surgeon Sheeraz Qureshi, MD, Co-Chief of HSS Spine and the study's senior author, began using a spine surgery robot to plan the placement of surgical screws in novel ways. His work sparked a shift in the way the HSS surgeons approached pars fracture repairs.

The new minimally invasive technique involves the placement of a single screw through a 1 cm incision — far smaller than traditional surgery to repair a pars fracture, which is performed through a larger incision and requires bone grafting. The robotic procedure is performed on an outpatient basis and is associated with an easier, shorter recovery.

Study: Robotic Pars Repair Allows Early Return to Activity for Adolescents with Symptomatic Spondylolysis: A Case Series

Dr. Kaidi, Dr. Qureshi, and their colleagues performed a retrospective review of nine adolescent patients with lumbar spondylolysis (mean age 16) who had robotic-assisted pars repair at HSS using the single-screw technique. Patients had endured back pain before the surgery for an average of 8 months. After surgery, they participated in an 8-week physical therapy program that started with walking and gradually re-introduced sports-specific exercises.

After a mean follow-up of 11.4 months, five patients had returned to the same or an even higher level of sports. One patient had residual back pain and did not return to sports. Three patients had CT scans at one year demonstrating union of the fracture. The athletes were able to return to activity in as little as six weeks. "Although nonsurgical treatment should always be tried before considering surgery, we were surprised by the effectiveness of this technique for enabling athletes to return to sport," said Dr. Kaidi.

HSS is a leader in robotic-assisted single-screw pars repair and one of only a handful of institutions worldwide who have published on this technique. This study is the largest series ever reported in these patients.

"This safe and effective procedure is changing the way the medical community thinks about these injuries. We are moving away from 'do nothing for 6 weeks' to a more elegant, proactive solution," concluded Dr. Qureshi. "Early minimally invasive spine surgery can prevent future complications. We're not only caring for patients while they are young, but also helping them in the long run."

Reference

Robotic Pars Repair Allows Early Return to Activity for Adolescents with Symptomatic Spondylolysis: A Case Series
Authors: Austin Kaidi MD, MSc, Michelle Zabat, MD, Amy Xu, MD, Adin Ehrlich, BS, Tomoyuki Asada, MD, PhD, Harvinder Sandhu, MD, Russel Huang, MD, Sravisht Iyer, MD, and Sheeraz Qureshi, MD, MBA

About HSS

HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the 16th consecutive year), No. 3 in rheumatology by U.S. News & World Report (2025-2026), and the best pediatric orthopedic hospital in NY, NJ and CT by U.S. News & World Report “Best Children’s Hospitals” list (2024-2025). In a survey of medical professionals in more than 20 countries by Newsweek, HSS is ranked world #1 in orthopedics for a fifth consecutive year (2025). Founded in 1863, the Hospital has the lowest readmission rates in the nation for orthopedics, and among the lowest infection and complication rates. HSS was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center five consecutive times. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State, as well as in Florida. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. In addition, more than 200 HSS clinical investigators are working to improve patient outcomes through better ways to prevent, diagnose, and treat orthopedic, rheumatic and musculoskeletal diseases. The HSS Innovation Institute works to realize the potential of new drugs, therapeutics and devices. The HSS Education Institute is a trusted leader in advancing musculoskeletal knowledge and research for physicians, nurses, allied health professionals, academic trainees, and consumers in more than 165 countries. The institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally. www.hss.edu.

HSS Researchers Report Benefits of Robotic-Assisted Spine Surgery for Adolescent Athletes with Back Pain Due to Pars Fractures

WASHINGTON (AP) — Homeland Security Secretary Markwayne Mullin on Wednesday rescinded a rule that DHS expenditures over $100,000 be personally approved by his office, ending a widely criticized policy implemented by his predecessor Kristi Noem that critics said put a particular burden on the Federal Emergency Management Agency ’s work aiding disaster response and recovery.

The decision marks the first major action by the new Homeland Security leader, sworn in last week, to change a policy implemented by Noem, whom President Donald Trump fired in March.

Mullin's move is expected to ease a spending bottleneck that lawmakers and states said delayed disaster response and recovery funds, though those impacts are unlikely to be widely felt until after the end of the DHS shutdown, now in its 46th day.

A DHS spokesperson confirmed that Mullin rescinded the rule Wednesday, telling The Associated Press the secretary “re-evaluated the contract processes to make sure DHS is serving the American taxpayer efficiently.” CBS News first reported Mullin's decision.

The spokesperson said Mullin’s action will streamline the contracting process and allocate aid more efficiently.

The International Association of Emergency Managers praised Mullin’s decision. “We appreciate Secretary Mullin’s common-sense approach to this matter, and we look forward to working with him,” said Josh Morton, president of IAEM-USA.

Noem issued a directive last June requiring that she personally approve any Department of Homeland Security expenditure over $100,000. Critics said the rule undermined FEMA in particular, an agency that routinely issues contracts and reimbursements well over that amount in its work preparing for and responding to natural and manmade disasters across the U.S.

The policy created “an untenable situation for emergency managers,” Morton said, and a bottleneck that also hindered mitigation and preparedness programs, “putting Americans at increased risk from disasters.”

A recently released report by Democratic members of the Senate Homeland Security and Governmental Affairs Committee found the approval rule had delayed at least 1,000 FEMA contracts, grants or disaster reimbursements by September.

The policy came under scrutiny after news reports linked it to unstaffed call centers and delays deploying FEMA Urban Search and Rescue teams to Texas during deadly floods last July, and brought sharp rebuke from some state officials and lawmakers, especially Republican Sen. Thom Tillis of North Carolina, whose state is still recovering from devastation wrought by Hurricane Helene in 2024.

“You’ve failed at FEMA,” Tillis told Noem at a Senate hearing the day before she was fired.

About $2.2 billion in recovery and mitigation dollars were in the DHS approval queue Wednesday, according to FEMA data seen by the AP.

“It’s got a great mission, and I think people at FEMA want to do their job,” Mullin told lawmakers at his March confirmation hearing, sparking cautious hope that he would ease the tumult experienced at the agency under Noem.

Mullin said he would keep the agency ”adequately staffed” after it lost over 2,400 employees last year, and said he was already considering nominees for a permanent FEMA administrator, which the agency still lacks.

Trump has repeatedly floated the idea of eliminating FEMA, saying as recently as Tuesday that the agency is “very expensive and it really doesn’t get the job done.”

Michael Coen, FEMA chief of staff during the Obama and Biden administrations, said, “Hopefully this a step toward transparency and stability between FEMA and states."

DHS is reviewing other policies across the agency, pausing the purchase of new warehouses for immigration detention this week as it reviews contracts signed under Noem.

Lifting the spending approval rule will not necessarily mean a rapid flow of FEMA reimbursements to states, tribes and territories, as the agency is still impacted by the DHS fund impasse, now the longest government shutdown in U.S. history.

While FEMA disaster response and recovery activities are paid out of a non-lapsing Disaster Relief Fund, that money is running low, a FEMA official warned lawmakers in a House hearing last week, with about $3.6 billion remaining. The DHS appropriations bill would add just over $26 billion to the fund.

Republican lawmakers on Wednesday signaled an agreement to end the shutdown could be reached in the coming days.

Homeland Security Secretary Markwayne Mullin speaks in the Oval Office of the White House, Tuesday, March 24, 2026, in Washington. (AP Photo/Alex Brandon)