An original technique of direct isthmic reconstruction described by E. Morscher was used in 25 patients with painful spondylolysis after failure of conservative treatment. After a follow-up of 25 months, the functional and radiological results were evaluated and compared with other techniques. Nineteen patients had an excellent or good functional result, in 2 patients the result was fair, and 4 patients had no beneficial effect on pain. The best results were seen in patients younger than 20 years, with an olisthy of less than 10 mm, without associated joint, disc or ligament pathology. In these cases, good results were achieved in 90%, and there was radiological consolidation in 100%.