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Bi-lateral pars defect - lumber spine

Started by Keo on 12/17/2010 6:04am

Hello, just registered on this site. I have a bi-lateral pars defect and have been offered a "bucks fusion", from what I can gather it will involve two screws being inserted to stablise the my lumber area. I have trapped nerve problems at the moment, comes on when I run for any length of time, the problem has pretty much kept me out of sport for the past couple of years,,,, does any one know of this type of surgery? Any thoughts / experience of the sugery welcomed i'm not sure if it is worth going through with or just deal with the nerve problem and adapt my sporting habbits.

Thanks

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I had the surgery for Bi-Lateral pars, they inserted 2 rods and 4 screws. However, mine did not fuse so 8 months later the had to do another surgery to remove the hardware and put bone cement in the L3 and L4 lumbar, I was also born without my L5 lumbar! I am 28 years old and I have been diagnosed with bi-lateral pars defect, Spondylolisthesis, a shattered thumb with tumor, and just today I had to have a Bone Density test! My dr. believes that I could have Osteoporosis, therefore causing my fractures!
To give you my honest opinion the rods and screws caused me more pain because of Failed-fusion than what it was worth!

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HI Keo..I too was told in November I have a bi-lateral pars defect at L4 and had to under go my 6th !!! spinal surgery. I needed a fusion for the "defect" at that site. I now am fused L5 and L4/S1. Monday will be a month from my fusion. My back pain at that site is gone and now i'm just having surgical pain. Maybe you can do PT and avoid surgery? Good Luck!

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Isthmic spondylolisthesis is probably the type of spondylolisthesis u have. I have this too. Mines a grade 2-3. It caused severe bilateral foraminal stenosis which resulted in significant bilateral root nerve commpression at my l5/s1 level. U probably developed ur bilateral pars fracture from a childhood pars defectr. It goes unnoticed as there usually isn't any symptoms until ur spondylolisthesis goes symptommatic. Have u tried all other conservative, non-invasive methodes first? Id advise this before ANY surgery. I wish u the best!!

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Thank you all for your comments and advice - Blazer, just to clarify - you say you have had 6 operations since knowing about your pars defect in November - were the others all related to your pars defect??

All,
I've pretty much givem up on playing sport so it only stops me running (which I have learnt to live with) BUT I was under the impression I risk having my pars defect "slip" (which at present it has not) IF it were to slip I'd then have no option but to have a formal fusion which would limit my movement...... having the op at this time when it is not that bad (hasn't slipped) is the best way of protecting against a slippage and a more serious op in the future - - that's what I have been led to believe....

Any advice greatly appreciated.

Thanks

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Actually these are the surgeries I have had:
2 laminectomies L5/S1, CSF leak repair, PLIF at L5/S1 and to fix the pars defect I had another PLIF at L4 almost five weeks ago. I have an excellent neurosurgeon at PA Hospital who did the last two fusion surgeries and hopefully "fixed" me for good this time. I can't imagine having another surgery. So far, the fusion stablized the "pars defect" and I have less pain then before the surgery!
What is a "bucks fusion"?

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My advice, if you have no foraminal stenosis or root nerve compression with your spondylolisthesis, thenid advise AGAINST any kind of surgery!!!!! Just becuz one has this doesn't mean their slippage will increase. Slippages can increase, don't get me wrong, however not everyone does and to have a surgery of this magnitude for the "potential slippage" just isn't worth the permanent effects surgery places on all the rest of the levels.

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I agree with you on that (not having surgery unless nerve root compression) cause fusion surgeries have very long recovery times and it is major surgery with all the complications that go with it BUT I did have nerve root compression and had to have surgery. Luckily i'm doing very well so far and wish everyone who needs surgery all the best!!

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I agree blazer, if a person's spondylolisthesis is not symptommatic, I wouldn't fix what isn't broken. If it IS, and every conservative method (chiropracic care, acupuncture, foot zoning, physical therapy, decompression therapy, injections, ect) has been done first, then surgery is warrented if it nothing else halted the progression of symptoms.

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Keo...how are you feeling? Did you decide whether or not to have fusion?

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Hello all, sorry for long delay. I did end up having the bucks fusion. Went through what was probably usual post surgery issues but not too bad. Was back to work within 8weeks. The fusion seemed ok - MRI was positive but the nerve problem remained and had occasional back issues / pain after training or activity. Now 1months later been told that the fusion didn't take as thought. Now left with another horrible choice - further surgery, same bucks fusion again (2nd time lucky), a full fusion of the two vertabra or leave and hope it eases off and doesn't cause a slippage. They say it has no less a chance to fuse on the 2nd attempt than first. I'm fed up!

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Hello all, sorry for long delay. I did end up having the bucks fusion. Went through what was probably usual post surgery issues but not too bad. Was back to work within 8weeks. The fusion seemed ok - MRI was positive but the nerve problem remained and had occasional back issues / pain after training or activity. Now 1months later been told that the fusion didn't take as thought. Now left with another horrible choice - further surgery, same bucks fusion again (2nd time lucky), a full fusion of the two vertabra or leave and hope it eases off and doesn't cause a slippage. They say it has no less a chance to fuse on the 2nd attempt than first. I'm fed up!

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