Figure 1: (a-d) 20-year-old female patient with unrelenting back pain for more than 1 year, x-ray showed double level pars defect at L4, L5. Intraoperative view (e) with an instrument pointing to the pars defect and (f) before and after application of the titanium rods. Visual Analog Score back pain score improved from 10 to 2 at last follow-up, Oswestry Disability Index score improved from 85 to 18 at last follow-up at 12 months. (g and h) showing complete bony healing