Surgery for an isthmic fracture is not a major surgery. The main principle of this type of surgery is to reposition the fractured vertebral arch, fixate the fracture and transplant the bone. This type of surgery is not a major operation because the scope of the operation is relatively small, which means that it is less traumatic for the patient, and the recovery after the operation is relatively quick. However, the positioning of the vertebral arch root is relatively difficult, as it is a very delicate location and is surrounded by important blood vessels and nerves, so it has to be positioned very accurately and operated with great care. Overall, this type of surgery is a routine procedure and not a very big one. If a patient has a disruption of the isthmus of the pedicle and there is severe vertebral instability, choosing surgery is a very good treatment option. Patients should not be overly concerned when they hear that their doctor is going to perform this type of treatment on them, as this type of surgery is technically very sophisticated.