Text Size: A A A
SpineUniverse Community Advice
Get help and share your story with others who know what you're going through.
Please register or log in to join the discussions!

L5/S1 Pars Fracture Sugery??

From: Bobby32C - on 11/09/2010 12:46pm

Gender: M
Age: 27
Height: 5'7"

Back Issue:
I have recently gotten an X ray from a Chiropractor in my area and he refused to work on me since he noticed a pars fracture at my L5/S1 vertebrae. I am in phase 1 of the L5 sliding forward in my lumbar. The chiropractor referred me to an orthopedic specialist who looked at my films and confirmed the fracture and explained the nature of the pain. He mentioned it is not life threatening and that if I decided against surgery it would leave me living a life, dealing with the pain, day to day and limiting my activity. When asked what he would do he replied that he cannot make that decidion for me. I am only 27 years old and have been very active up until the last 2 years. I haven't gained an excessive amount of weight although my percentage of body fat ratio has turned for the worse. i would like to become very active again although I do not see that happening with my levels of pain without the surgery. My family is very tentative for me to have spinal surgery. I am looking to seek a second opinion although I think the next Dr. will tell me the same thing. I just wanted to see who else is out there that is going through similar issues that has/ has not decided to do the surgery. I believe it is in my best interest to have the surgery although my family keeps me from thinking it is the right choice. They are not the ones dealing with the pain day to day and the activity limitations day to day. If anyone has any insite about this please reply. i am just looking for some information.

Background:
I have played sports my entire life including football through high school and non competitive through college. I have always lived an active lifestyle until recently. With any kind of high level activity I cannot bear the pain from my lower back and legs. Standing in cold weather for excessive amounts of time also will make me very irritated. I was forced to quit snowboarding and lifting weights amoung other things.

Any information is appreciated

Do you find this discussion helpful?
1

30 Responses

Like/Dislike
1
on 11/15/2010 6:02pm

Hi Bobby32C -

I feel your pain...and I face the same dilemma... I found out over a year now, heading toward two.
I just had another MRI and there has been no further slippage, which is good!
My diagnosis is similar to yours. ( L5-S1 Spondylolythesis with pars fracture grade 1 slippage.)
The surgical treatment for this condition is a spinal fusion w/hardware. But...Without going
through my entire ordeal...I'll gladly share some things I found out:

1. Try to 1, 2, even 3 opinions if you can..ortho/neuro whatever.Find a surgeon (board certified) in spine surgery. I don't know if you live near a large metro area..but if you do..check them out.
I've gotten several opinions from other Drs., neuro & ortho, and even went out of my area to a larger hospital system. I decided to stick with my ortho guy who is board cert. and is very approachable.
He answers all my questions about (like they use titanium rods & screws, he prefers using bone from his patients instead of man made material etc.) Trying to find a surgeon who will have open
dialogue with you isn't always easy! Also logistically, if you go out of your area for the surgery and
have even minor complications, you'll have to travel back & forth...a friend had a problem like that after cancer surgery - no dr in her area would see her so she had to trek back & forth..

2. Read all you can and talk to the Drs..your physical therapist, even your regular md.. I have found out basically that a grade 1 slippage kind of falls into a grey non-surgical treatment category. The
books, and drs will usually tell you that UNLESS there is a mechanical problem like drop foot, or caudia equina (incontinence). then all non-surgical treatments are the reccomended treatment.
like a series of Epidural injections, Physical therapy, and a combination of meds. (Right now, I have done 4 epidurals (which is not too good actually) You can get up to 6 a year, but if you need that many than safe to say it's not a good treatment option..Plus over time the epidurals themselves can cause side effects. There are medications too, like I take Neurontin for nerve pain. It is not a pain med..(it's actually for seizures but they found out in studies it works well on neuropathic pain....like for diabetics with foot pain )...I know someone with a back condition who tried neurontin
which did nothing yet got relief from Lyrica. THEN- there are the 'pain meds'! which alot of drs. are
reluctant to prescribe because some people rely 'only' on them, which is not good. There is
accupuncture, massage therapy, water therapy, etc... You could ask your dr. about trying try them
to see if any work at alleviating enough pain so that you can become active again.

3. Try all the different things your doc may suggest...surgery should really be your last option.

As for me..I have tried all these things...In the meantime I too have maintained my weight, even
though I've had a dramatic reduction in activity..Though older than you; I am former law enforcement,
and was very active..hiking, swimming, workout, and my forever favorite softball. I have not been
able to return to any of these really..and even with surgery...you have to retrain yourself..how you
lift things etc...(the biggest drawback to surgery - the fusion weakens your other vertebre, above and below) but talk to your dr. about the chances of that (I've gotten mixed messages on that!) I am still
going to PT (if only to strengthen core muscles, a must whether you have surgery or not!). I am
still on the fence about surgery..but am learning as much as I can before I decide.

Good luck...
I hope this information was helpful...
Maggie1422

Like/Dislike
0
on 11/15/2010 9:03pm

Maggie,

Thank you for your response. Just to answer a few of your questions. I do live near NYC and have begun seeking opinions from the hospital from special surgery. I hope to have an appointment scheduled sometime in the near future with one of their surgeons.

When I met with the Orthopedic surgeon two weeks ago he was not shy about explaining the concept of the surgery and what exactly was involved. He probably could also tell that I had done quite a bit of research before I had gotten there based on the information I brought into his office. He showed me diagrams and before and after x rays of what would be going on if I chose surgery. He too uses human bone for grafting rather than an artificial kind. He seemed very knowledgeable and explained everything clearly to me but with this being such a major surgery I thought seeking another opinion or two couldn't hurt.

When I spoke with both him and the chiropractor that referred me to him, they both mentioned that without surgery, any other means would just simply be a band aid for the issue. He said the fracture will NOT heal itself without bringing the vertebrae back into place via the fusion. This was another reason I wanted to seek another opinion. I went to the Dr. the chiropractor recommended and I wanted to see what someone outside of their relationship would think of my condition.

As far as the drop foot you were speaking of, I have noticed quite of big difference in the way my feet position themselves while I'm laying down on my back. My calves seem to be getting tighter and tighter as time progresses and seems to create more of what I think "drop foot" would consist of. I still have flexion and extension from the ankle joint although it seems to be limiting itself slowly over time.

I am hoping to see one of the Dr.s from the Hospital for special surgery within the next 2-3 weeks so I will keep you posted with any more updates. If you live near the NYC area and have any Dr. recommendations I would greatly appreciate it.

Thanks
Bobby

Like/Dislike
0
on 12/08/2010 11:12am

Hi Bobby,
So sorry to hear you are going through this. I'm just now reading your post from a month ago, so I hope you've been able to find some answers. My daughter also had a pars fracture at the L5/S1 vertebrae,and was also in phase one. Hers was bilateral. She was only 14, but we decided to go ahead with pars repair surgery because she was in extreme pain - could not sit at the desk in school, etc. Her surgery was Sept, 2009. Like you, she's an athlete - soccer, track. It was a difficult year. The surgery took about 5 hours, and she missed about a month of school her 8th grade year. She did physical therapy, etc. for months. It was a long road, I won't sugar coat it!

She got clearance to return to soccer about 10 months after the surgery, just in time for high school tryouts. She made the JV team her freshman year. Later, she was moved to varsity and also was named MVP of the JV team. I only tell you this because I would like to give you some hope that you can recover from this. Because of her young age, she had "pars repair surgery" instead of a fusion. She does have the hardware in her back. At 27, you are still pretty young. You might ask your doctor about this option?

The one concern we are still having about her surgery is that her bone graft has been slow to heal. She will have another CT scan in January (about 15 mos. post-op) which will determine if the bone graft is healed. At that point, we may need to discuss a second surgery to try the bone graft again. Then, if the bone graft still does not heal after that, we'll talk about doing the fusion. Fortunately, our doctor thinks her back is providing sufficient support to her, since she has been able to play soccer and has had very little pain. That means either the bone graft is healing, or that it may not be 100% but it still is strong enough to provide the support to her. We're hopeful that a second surgery won't be necessary.

We've heard from many people who have had multiple back surgeries, so we knew that could be a possibility. Still. we are very glad that we chose surgery for our daughter. She is pain free and happy for now! Of course, surgery is not something to take lightly. I hope you are getting second opinions, and that you have a very good orthopedic surgeon in your area. Good luck! Sheila

Like/Dislike
0
on 12/08/2010 12:32pm

Sheila,

Thank you for you response and encouragement. I hope your daughter continues to get stronger and does not have to go through another bone graft operation. My thoughts are with her.

I have just recently been to see a specialist in my area (NYC) at the Hospital for Special Surgery and her confirmed to my family and I that this surgery (given all goes well) will relieve the pain and limited range of motion I have been experiencing. He gave me an optimistic time frame of 3-6 months of full recovery. He said about 3-4 days in the hospital post op, one week or so of limited movement recovery, and another 1-2 weeks before I can drive or really take care of myself.

One thing that he noted was that in this day and age he hasn't had many issues with the bone graft not holding. He mentioned that in the past it was an issue and a cause for concern although with modern medicine making progress that it has it seems to be an issue of the past.

He was very thorough with his evaluation and he took time to explain everything to my family and I regarding the situation and what to expect. Given the amount of time he spent with us he certainly helped me feel more comfortable making a decision. I am in the process of deciding when to go through with the surgery although the cold weather seems to really be hindering what I am capable of doing.

Please stay in touch I would love to hear how your daughter is progressing in the future. Have a happy holiday.

Bobby

Like/Dislike
0
on 12/08/2010 2:15pm

Hi again,
Sounds like you received good news! Hopefully, you can proceed with the surgery soon and begin your road to recovery. I can imagine you're in a lot of pain right now, and anxious for some relief. I think I mentioned that my daughter's fracture was bilateral. One side did heal pretty quickly (3-4 months) and basically the other side is what we're waiting on for the bone graft. So, most likely you will heal more quickly. She has used a bone growth stimulator (like a back brace) 4 hours a day, to stimulate bone growth, so you might ask about that. Also, remember not to take advil after the surgery. We knew not to take it for 2 weeks prior to surgery, but no one said anything about after surgery. When her prescription pain meds ran out, she was taking some advil. Luckily someone told us it inhibits bone growth, so she switched to tylenol. Again, best of luck to you, Please keep in touch as well. Sheila

Like/Dislike
0
on 12/08/2010 3:13pm

That's very helpful information thank you. I will continue to make comments as things continue. Best of luck to your daughter.

Bobby

Like/Dislike
0
on 12/13/2010 7:41am

Hi all, came across this conversation by accident, so joined so as to let you know my experience with the exact same condition and a procedure that's not widely known and doesn't have the same potential ongoing issues as a spinal fusion. I had the surgery 2-weeks ago and am sitting at my desk - no pain - fixed L5S1 pars-defect on both sides! Sounds amazing, read on!

I'm 43 years (male) living in the UK and have suffered with a back condition since my teens. Along the way I've had numerous diagnoses for my condition from both Harley Street (London) and private health care. As a very active sports person, I've always been fit and kept in shape, however since reaching 40, I noticed a large decline in my condition and sought renewed advice. I saw a spinal specialist in London who dealt with professional sports injuries who first advised me of the extent of the condition. After X-rays, MRI's and CT's, they advised me that I had a Level 1 Spondilylothesis at L5/S1 (i.e. pars broken on both sides, Spine slippage 1-1.5cm at full extent). The advice at the time was that I also had very damaged discs (5) and that the operation was too severe for a person of 40 and that I should take pain killers and take life easy.

I must confess, that frightened me a little as (1) I was extremely active and (2) what was to become of my future if this continued to worsen. Anyway, I did as he suggested and started to take pain killers (30mg/500 Co-codamol and 50mg Diclofenac). Worked a treat and for a while I was in less pain. At that time I was told to stop running, weight-lifting and doing anything that put strain on my spine. I did however continue playing golf for a while until that became unbearable. Over the next 3-years, I went from a packet of pain killers lasting me 6-months to 6-weeks. Earlier this year, I needed pain killers just to get through the day. 1 hour tending the garden and I could hardly move afterwards. In the morning I would walk around like a 90-year old for an hour or so until the pain subsided.

Earlier this year I decided to re-investigate the issue and fortunately and by pure luck I happened to pass a Spinal Clinic near to a client’s office so I popped in to find out more. It so happened the specialist provided spinal rehabilitation to professional Cricketers and was particularly experienced in this exact defect. The reason being that this condition is particularly common in fast spin bowlers (Cricket). Anyway the gentlemen suggested I see a specialist surgeon who has provided an alternative repair that tends only to be commonly used for professional sports people who's livelihood depends upon a fully working spine. I immediately went to see the surgeon who told me about a procedure called a 'Bucks Repair' or otherwise known as 'Spinal Screw Fixation'. The advantages of this procedure is that afterwards, you have a completely operative spine as though the injury never occurred as oppose to a spinal fusion where you will lose a small amount of spinal mobility (also less stable). Spinal fusion is like gluing 2 pieces of wood together whereas Screw Fixation is screwing them together. The screwed wood is immediately strong and very unlikely to separate. No waiting for a fusion to take place. 18-months later the graft would have fully joined and the screws become redundant - however left in as no need to remove and act as extra strengthening.

This procedure involves taking bone grafts from the hip, inserting the grafts between the breaks and then drilling holes through the pars-defect, the graft and the vertebrae and then placing 2 titanium screws through to fix the spine. All sounds pretty horrific, but please read on as it's not as bad as it sounds. Anyway, being a person who was not going to accept life in a chair, overweight and bored, I pursued this option. The surgeon told me that assuming all went OK, I would be running, golfing and doing all that I wanted within 3 months of surgery. I would have nothing more than a 2-3 inch scar on my lower back. On the downside, the recognised success rate for this surgery was 50-60% complete success, 90% improvement and only 10% worse off. That was 90% chance I would be better off which was good enough for me. Alternative was to spend my life as a couch-potato, wondering If maybe I could have been fixed. Not a good thought.

OK so, I went in for surgery on 23rd November this year. The operation lasted about three hours. 3-hours after I awoke, I was on my feet shuffling tentively to the lavatory. Today I’m sitting at my desk at Home, fully mobile, no dressing on my very minor incision which is pretty much healed. Within a couple of days, I could immediately feel the additional support in my back and when I now sneeze or cough, I don’t wince in pain. It’s clearly too early to tell how effective the surgery has been as 6-weeks needs to pass before everything will have settled down. They have to stich the back-muscle and amazingly they glued the incision so that no scaring will remain. You can hardly see it now. However, when I get up in the morning now I have no pain and can walk immediately. I no longer feel 90!

My back still aches a little, but it feels more like a post-operative ache than anything previously and definitely a whole load stronger. Here’s the amazing part, I haven’t felt a single bit of pain regarding the surgery on the spine whatsoever. I have had worse paper-cuts. OK so I’ve been on pain killers for 2-weeks, but I’m now off them completely. The bone graft aches a little but should subside within 6-weeks or so. Put it this way, any pain I have felt has been a lot less than the pain experienced over the previous 25+ years. 2-days after surgery, I was walking and climbing stairs – no problem. Before surgery I had no idea what to expect post-operatively and my thoughts were of me on crutches, struggling and in pain. Couldn’t have been more wrong. I spent the past 2-weeks pretty much lying down or standing as they don’t want you sitting (i.e. 90 degrees) as they want minimum stress on the spine and muscle etc.

I’m not saying that anyone with this condition should read and jump on this as an option. Everyone responds differently to surgery and I’m sure everyone’s condition differs. I only wish someone could have told me about this and me not to have only found out by chance. My philosophy on life has always been to do, try everything, no regrets. If it didn’t work out, the chances of me being worse off were pretty slim. Not going to live my life wondering “What if”.

Hopefully this will help someone make a choice, better understand or maybe give an insight into a procedure you were unaware of. Whatever, live life and control it, don’t let circumstance control you.

If you want to know more, then please don't hesitate in contacting me (scott.hews@live.co.uk if you want to keep it private).

Like/Dislike
0
on 12/13/2010 12:05pm

Yes! This sounds like the surgery my daughter had. You explained it much better than I did. But yes, it involved a bone graft from her hip, and she does have the titanium screws which will remain. Our doctor called it "pars repair surgery" and the results so far have been great. She is no longer is pain, and is playing soccer. thanks for adding to the discussion - I'm sure it will be helpful to others!

Like/Dislike
0
on 12/17/2010 2:06am

Hi Bobby - Just read u went to the Center for Special Surgery...I think it is listed in top 3 for spinal
surgeries so you can rest assure you got an excellant evaluation..You should feel quite confident
in having gone to such a great hospital. But I can understand, and relate, to your feelings about
the cold weather..it is dibilitating! Some days I could just jump right up on the surgical table
and say DO IT!

My surgical consult is Jan 19. I just had my last epidural the week before Thanksgiving and can feel it wearing off already.. but hoping it lasts through Christmas ....got the family coming :O

My surgery will be basically the same as described by some of your previous posts. It will be
a fusion, using my bone, and includes a titanium rod and screws. My surgeon even said they went back to using your own bone as opposed to cadaver or the man made material because they found the body doesn't accept the cadaver bone as well and 10 years of using the the man made material has shown it isn't holding up as well as originally thought.

I'm just not sure about having nerve studies before the surgery and was wondering if your doctor had mentioned anything about having them done. I have alot of nerve pain, actually more so than mechanical pain. I could kick myself that I forgot to ask him about this at my last appt. Any info
on nerve studies that your doc may have mentioned would be greatly appreciated.

But in the meantime... Hope all enjoy the wonder of this Holiday, relatively pain free! Maggie1422

Like/Dislike
0
on 01/10/2011 1:57pm

Just to follow up - we had some great news at my daughter's appt. last week. It was 15 mos. post-op, and she had a CT scan to determine if the bone graft is working, or if it's basically being absorbed by the body. The short story - One side is completely healed/calcified. The other side is getting there, although still not quite 100%. Our doc said this indicates it will continue to calcify and that it's providing enough support for her back. At least her body is not absorbing it, so that's good. We are not even discussing further surgeries.

The longest our doctor has ever seen it take someone to heal is 15 mos., so her recovery is longer than usual. Most recover within a year, if that helps you. We'll have another appt. in Sept, 2 years post-op, and we expect her to be 100% by then. In the meantime, she has been playing indoor soccer with no restrictions, and is feeling great. It was tough to sit out of sports for a year while she recovered, but it was worth is as she is now pain free and back to her sports. i just wanted to share that for those of you considering pars repair surgery. Good luck!

Like/Dislike
0
on 01/14/2011 1:57pm

Maggie and Shiela,

Thank you for your replies. I apologize for taking so long to get back on the discussion board. It was a busy holiday season and back to work in the new year :).

Maggie - I wish you luck as your surgerical date gets near. I hope you haven't been feeling too much pain through the holidays and was able to enjoy them with your family. I am scheduled for a pre admission date on February 10 of this year to have the same neurological testing performed. From what I understand is that the Dr. and team of Dr.'s want to be sure they have as much information going into the surgery as possible.

Sheila - I'm glad to hear your daughter is continuing to show progression with her bone graft. It seems like she will be on the road to 100% recovery by September.

This website (forum) has been very helpful for me to have as much peace of mind given the situation. Thank you all for posting and offering the information you have. Right now I am scheduled to have the procedure performed on February 14th. Happy Valentines day!! Well atleast I won't have to deal with this back pain following the recovery. I wll continue to post as more information becomes available to me and I have the operation done. I may even turn this forum into a blog post while im layed up in bed for a few days.

Best of luck to both of you and your families in your and their recoveries going forward.

Bobby

Like/Dislike
0
on 01/16/2011 9:26am

Thanks Bobby...Hope you had an enjoyable holiday as well. I go to my surgeon Jan 19, this Wed.
Please let me know how your neurological tests go. Good Luck...Keep us Posted.

Like you, I hope to keep the dialogue going. Drs. can't share patient information ofcourse, but we can share our own experiences. This site has been great, glad I logged on to it. I have never joined a chat room or community board but am thankful I did. Looking to move forward in 2011!

Like/Dislike
0
on 01/16/2011 9:34am

Sheila M - Such Great news for your daughter and you I'm sure...I hope she will be continue to
get stronger and the other graft will be complete...in time for spring soccer! Best of luck!!

Like/Dislike
0
on 02/02/2011 11:30pm

Sheila M- My daughter is also an athlete (Gymnast) has a bilateral pars defect and has not participated in any sports since last May. Have tried PT, rest, and meds. No real change in pain. Dr. is pushing for surgery, but I have had concerns due to her young age. Reading your post gives me hope that all will be okay with the surgery. They are talking about fusing L4-S1, but I will definately ask about the pars repair. Happy your daughter had good news at the last visit.

Bobby- keep me posted about your surgery.

Like/Dislike
0
on 02/03/2011 3:25pm

Spondymom,
Yes, I would definitely recommend asking about the pars repair, as opposed to fusion. Our doc told us he would only do a fusion if the pars repair wasn't successful. He said his rate of success with pars repair was about 92%, so we went with that. It was a good choice for our daughter. I'm sorry to hear about your daughter! Feel free to ask me anything, and I'm glad to help if I can. I remember being so worried and trying to find answers!

Like/Dislike
0
on 02/05/2011 7:54pm

Hi Bobby,
First, I want to wish you good luck for your upcoming surgery!!! I have had too much experience with spine surgeries cause I've had a few including spine surgery 7 weeks ago. I needed a Fusion (PLIF) for a Pars Defect at L4/S1. The other surgeries were due to Degenerative Disc Disease....The severe back pain I had due to the defect is already going away and I now just have surgical pain. It is a long recovery but well worth it in the end especially for someone as young and good shape as you are. If you have any questions about the surgery/recovery I'd be happy to share my experience. The Hospital for Special Surgery is the best place for you to be!!!

Like/Dislike
0
on 04/13/2011 12:35pm

I apologize for not being more responsive to this post. I just recently returned to work part time, at least for a few more weeks until my Dr. fully clears me. The Dr. gave me great news following my surgery that he was able to install a spacer where my disc was completely drained and compressing the nerve. The hardware went into place as expected and when I came out of surgery the prior pain was relieved immediately. I had to deal with the post op pain for a few weeks but I was home two days after surgery and off my pain meds by one week after surgery. I feel I have definitely had a successful recovery so far although I feel my back beginning to develop more pain than in the past few weeks. This could be due to more involvement in day to day activities. I will see the Dr. again on April 27th for my second follow-up and hope to receive my prescription for PT. For now I am still limited to walking and swimming if possible although NY weather has not been conducive to that just yet. If there is one thing I would want to be able to do at this time would be to stretch. Everything in the lower part of my body feels exceptionally tight and I feel it will definitely benefit me. Once I see the Dr. again I'm hoping he allows me to start that part of my recovery. As far as the recovery, I couldn't have asked for a better procedure. The hospital staff was exceptional and the Dr. did a great job. I will follow-up again once I visit the Dr. on April 27th.

Like/Dislike
0
on 04/14/2011 8:19am

Bobby,
So glad to hear your surgery was a success! I know it's frustrating when you're anxious to get back to your regular activities. I hope your follow-up appt. goes well, and you are given the okay to do a little more. Please take it easy though, and give your back time to heal! I'm sure you'll be back to your sports soon - probably better than ever because you'll finally be without pain! Take care, Sheila
PS. My daughter is doing great. To watch her play soccer and run now, you would never know she had major back surgery just 19 mos. ago. You'll get there!

Like/Dislike
0
on 04/28/2011 4:48pm

So after my 2nd followup with my Dr. it appears that I am on track so far with my recovery. The x ray showed everything as he wanted to see. I should begin PT in about two week (12 weeks post surgery) and I am expecting to do that for about 6 weeks. On the downside, I was able to speak to him regarding some neck pain I have had in the past and after reading the cervical MRI it appears that I have bone spurs at c2/c3 and c4/c5 which has led to pain at certain times in the past. After finding out this information it seems that these disorders could be forming due to degenerative disc disorder. I am going to have to continue to heal my lower back but my need to deal with the cervical issues in the future. I will keep posting as I progress with my PT. Is there anything out there to help prevent or slow further disc degeneration??

Like/Dislike
0
on 01/24/2012 1:56am

I have had the L5S1 surgery first one in may of 06 and then had to have a secound surgery in oct of 06 a lambectomy they were both failed surgerys i am in pain every day suffer from depression the only good thing is just this past year the military finaly gave 100% disibailty same with ssi so now i am able to at least do things to try to get my mind off things if you want a secound opion i would find you a nuro surgen to look at you they aproach things in a whole diffrent way they still may want to do surgery but have a much better out come with there surgerys i have thought about a third surgery do your reserach and good luck. I had my surgurys in minnesota now i live in georgia it reallyhelps not haveing the super cold weather.

Like/Dislike
0
on 03/09/2012 1:59pm

Hi Bobby,
I am in a very similar situation. I have Sponylolithesis with a grade one slippage and bilateral pars fracture at L5 L1. I am 26 years old. My background is in dance and yoga- which could have aggravated the congenital spondy. The initial injury happened 9 months ago and it was aggravated 2 months ago. For 7 months I pretty much lived pain free and thought I was in the clear. I saw an Orthopedic Spinal Surgeon at George Washington Hospital in DC and he confirmed that I would need surgery but that when is pretty much up to me. He is sending me to get facet injections and PT for 6 weeks. The facet injections are awful- top 5 most painful experiences of my life. I have 2 more to go and I am dreading them. He said if we did the surgery he could do it laproscopically through my abdomen and I would have minimal recover time. I am going to see another Dr. at Georgetown University next week for a second opinion.

At this point I think I am ready to have the fusion. 1st, I have Fibromyalgia and the best treatment is exercise. I usually exercise 6 days a week for an hour and since I have hurt my back I can't do anything. Therefore, my fibro is worse. 2nd- I want to have kids within the next 4 years or so. Every doctor has told me that it would be extremely dangerous for me to carry a child with a pars fracture. 3rd- It hurts and I want to feel better :) I'm just not sure the risks of surgery outweigh the benefits at this point. If I want to have kids by the time I'm 30, I'm guessing that at the latest I would want the surgery done when I am 28 (a full year to recover, just in case, and the time of actually being pregnant). So if I am going to need the surgery within the next 2 years, I'm thinking I should just have it now so I can get back to physical activity.

Any thoughts from anyone here? Any thoughts on the long term risks- i.e. spinal degeneration of the surrounding disks? Thanks for you help in advance!

Nicole

Like/Dislike
0
on 08/16/2012 4:55pm

Hi Nicole,
I just found this thread and it is so nice to finally get connected with a support network. I particularly related to your story because I am a yoga teacher and have a 2nd degree spondy at L5. I had my first episode of pain at age 13, but was not given proper attention, so didn't get diagnosed then. At age 21 I developed sciatica, which led to PT, but still no pars diagnosis. Not until 2006, when I was 31, did I get diagnosed with the pars defect and 2nd degree spondy. I had been doing yoga and teaching for 7 years already and done an extensive amount of extreme physical contortion. At that point the doctor said to continue being active and watch the condition, but that pregnancy was probably not a good idea. At the time I thought he meant that carrying a pregnancy would be risky.

Fast forward 6 years. I continue to teach yoga, started my own studio, and have a 2 year old daughter. I did yoga every day through my pregnancy. I must mention I stopped doing advanced practice in 2006 and have tried to stick to gentler classes (no scorpion on a regular basis). I did great through my pregnancy and didnt have any big issues except pain in my left foot. 2 months ago I developed sciatica again, this time in the left leg. I believe that carrying/lifting my 27 pound girl and teaching 15 classes a week is what is causing it. Regular chiropractic helps, but it is getting hard to afford. I have avoided surgery at all cost because of the many people I have met that have had complications afterwards.

I guess I am here to say, try all other options first. Do gentle yoga, avoid deep twist and backbends. Keep active as much as possible and don't underestimate the power of massage and a clean diet. I definitely feel worse when I am eating things that clog the digestive system. Keeping the abdomen strong and clean and the low back muscles supple is so important to being pain free. I am going to try to go another 2 years without surgery. After 6 years of constant yoga and a pregnancy my spondy has remained at 30 degrees. I delivered at home with absolutely no medication and it was a beautiful experience. Surgery will not guarantee a problem free experience with pregnancy and child rearing. We have sensitive backs and will always have to be mindful and careful with ourselves. Think of it as an excuse to ask your husband for help. If your husband is not extremely generous and patient....don't even consider having kids....it is hard enough without a back problem, impossible with one. He will be the one giving horsey rides every night...not you!

Good luck everyone and I look forward to staying connected!
Katie Kegg, RYT, LMT

Like/Dislike
0
on 08/21/2012 10:25am

Hi Katie,

I did actually end up having surgery- ALIF through the abdomen- after trying every possible non-surgical option. Since I have spondy with the broken vertebra, and a torn disk, surgery was my only real option because pregnancy would have been dangerous, I wouldn't have been able to travel internationally for work without fear of it getting worse, etc. I figured I was too young for that :) So, although surgery was not my first choice, I'm glad I did it. 2 1/2 months post surgery, I'm still not 100% but that because the vertebrae have not finished fusing. My doc said some people feel better right away, but since I had the break with the spondy and the torn disk, I might not feel better until the 4 month mark. I'm nervous about the possibility of it not working as planned, but I am glad that I eliminated the risk of it getting worse.

Thanks so much for your comment. I took a lot in before I made the decision for surgery. It was a rough 6 weeks or so after surgery, but now I'm on the mend! Hope all is going/ will go well for you! I don't know if you have talked about the type of surgery yet, but I went with the anterior approach because of fewer risk factors and they didn't have to cut any major muscles (just one tendon). I have a tiny scar on my stomach and that's it. I would recommend the front approach.

Like/Dislike
0
on 09/08/2012 5:37pm

I am so glad that I have found this post. I've been having issues for quite a while that seem to be getting progressively worse. My MRI says Pars Defect bilaterally with 3mm anterolisthesis of L5 on S1 and significant facet arthopathy/hypertrophy at the L4/L5 level with mild to moderate foraminal narrowing (stenosis). I've done PT, chiro, injections, nerve deadening, ice, narcotics, TENS treatment, massage, NSAIDs, etc and things are still getting worse. Last time I saw my doc he ordered a discography/discogram to determine not IF I need surgery but what kind of surgery I actually need. I have that test in a couple of days. I have been freaking out because I have heard nothing good about the fusion surgery or any back surgery and everyone tells me at 31 I am too young to have it. You guys have given me hope that I will be able to have a surgery and at least get mostly back to normal. I have always been active, including playing sports at the college level, and I haven't been able to lately. I know there is always risk and pain involved but now I also know it doesnt have to be the end of the world.

Like/Dislike
0
on 02/24/2013 4:35pm

Hi bobby

Can you tell me the doc that dis your surgery at hospital for special surgery? I need same surgery. Thanks

Like/Dislike
0
on 04/25/2013 2:57am

Pars repair surgery is a real solution. This website saved my life. I read the post by Scott Hews and I have just had the same procedure of a direct pars repair called a Buck repair. I will post more when I can sit at a desk properly

Like/Dislike
0
on 06/09/2013 6:20pm

I am now 7 weeks post surgery that is a direct pars repair with titanium screws not a fusion.
I just had an active weekend, driving, swimming, taking my kids to parties etc, stationary bike in gym with low resistance but no weight lifting or heavy exercise yet.
I did not take a single pain killer all weekend, not even Tylenol. I did switch on my SUV seat warmer for a few minutes for minor twinges and thought about a a hot bath but did not get time.

It is really important to differentiate fusion from direct pars repair. I found my surgeon in the UK after reading this forum. Google John Dowell and Buck repair and read entries by Scott Hews on ths site

Like/Dislike
0
on 06/27/2013 4:07pm

Bobby 32C was wondering who your Dr. was a HSS? I have consulted with a Dr. there and another Dr. in the White Plains area. Both are very good but undecided which way to go. Dr. at HSS uses autograft (hip bone) while the other uses autograft.
I would love to hear who your Dr. was and your outcome and experience. I was very discouraged because all I see on the internet is bad experiences until I came across this site.
Thank you

Like/Dislike
0
on 06/27/2013 6:19pm

hello.I'm farnood asadi and nineteen years.i'm in pain for about a month due to the spondylolysis .what's your idea for me?
I have radiography of my lumbar that illustrates low spondylolysis with probably pars fracture.
now I am waiting for your help and experience about cases like this.please reply.
thank you so much.

Like/Dislike
0
on 05/27/2014 2:58am

just a run down on my back history might help im 51 in 98 i had a fusion of l4 l5 and have been in pain ever scince getting worse every year until now 2014 the pain and siatica is un bearable now S1 and l3 have gone s1 has prolapsed and l3 has pars defect had 2 ct guided steroid injections ,now they want to operate again take the screws out of l4 and join up th metal work to l3 somthing along those lines just got back from orthopedic srugeon today thought i would look up pars defect and came across your post
i wished after the surgey that i should not have had it the pain was worse after now they tell me that after a fusion you only have about 5 years till you have problems with either above or below

Cancel
Delete