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Am I prolonging the inevitable? Spondylolithesis, Physical Therapy and Pregnancy.

Started by a_m_b_e_r_2011 on 06/10/2011 7:19pm

Hi There-

I am a 22 year old female who just recently got diagnosed with Spondylolithesis L5-S1 grade 3-4. I've only seen one orthopedic surgeon so far, I have a 2nd opinion scheduled at the end of the month. This surgeon wants me to try physical therapy to prevent further slippage. And I am going to start PT with in the next few days. But basically what I am wanting to know is, am I prolonging the inevitable? Will I eventually have to have surgery? Is this something that after time goes on it just gets worse?

I started complaining about sciatic pain when I was 14-15 years old. I was in cheerleading and gymnastics (which is probably what caused this, or I was born with it) and have since then put on a little weight and have had one child. My pain started getting even worse after I delivered my daughter. So in my opinion since time has gone on this has gotten worse for me. I am wanting to have more children down the road, but I am terrified of what another pregnancy and delivery might do to my body.

My pain is something I’ve learned to live with, but it is severe. It wakes me up in the middle of the night, it prevents me from standing for long periods of time, I can’t walk long distances without needing to rest, standing up first thing in the morning (when my pain is the worst) to shower is so painful and sitting in certain positions is very uncomfortable too. Just to name a few. But it is something I’ve learned to live with and manage, I think this is why my surgeon suggested PT first instead of jumping into surgery.

So basically I’m just wondering if anyone thinks that I am just prolonging the inevitable? Will I eventually need to have the surgery? Should I do it now before I try to have more kids, that way I can try to get my life back to normal pain free? Or do I keep living with this and try to maintain the slippage with PT? And does anyone have any info or stories to share about being pregnant with Grade 3 or 4 spondylolthesis?

Thanks in advance!!

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3 Responses


No one can answer this for you if you are prolonging it. It is up to you....Also how well you respond to conservative methods.I have heard most people with high grades do not respond well to conservative methods. But I would try it and do everything your pt says. Also if you haven't yet, you should get an x-ray of you in different positions, to see if you are actively slippling when you are bending over. If it shows you are, surgery would be your only option from what I have been told.

I have grade 3-4 spondy on L-5/S-1. I got founnd this out in February. We think I was born with it, because I have had no trama. Also I never had back problems or any problems until February, when I started having servere leg pain when walking. I have been doing pt since April.. But I am lucky that my back pain is mild. I have numbness in my right leg after walking to long. I probably will have to have surgery. But I am waiting as long as possible to have it. I can live with this for now.


Hi Amber,

Like Jacqueline said, the decision to have surgery ultimately rests with you. I might suggest getting opinions from both and Orthopedic surgeon as well as a Neurosurgeon. I've consulted both and will likely be going with the Neuro, mainly because in my mind, my nerves are more important than my bones! LOL!

I, too, have Spondylolisthesis (Grade 2-3), as well as Spondylolosis (pars fractures) that is unstable, and a flattened, herniated disk at L5-S1. I've been dealing with flare-ups over the years, but they are getting really bad and it ain't lookin' good! LOL!

My Neuro said that ultimately it has to be done, but I have to make that decision. All my consults over the years see to say one thing consistently - try to put off the surgery until you absolutely can't take it anymore - or it is unstable and/or dangerous to leave it alone.

Mine has gotten really bad and I'm pretty much resigning myself to the fact that, if it absolutely HAS to be done, which I'm told it does, I'm getting over the stress of prolonging it and the pain is a constant battle each and every day.

So I suppose that check with your docs and weigh the pros and cons for yourself. It's a big-deal type of surgery, but if you need to have it corrected - maybe it's best to do it while you're still so young and recover better/faster.

Good luck and please keep us posted! :)


You'll know it's time when the pain is unlivable. You simply can not function doing the basic of going through the day. By all means follow the DR's orders.. Do the conservative treatments this works to your favor when it comes time as the insurance company see you tried everything you can possibly do. Also take the meds that you were given. I was in a similar situation - I am glad that I waited as long as I could. I had already visited the surgeon a year or so. He said that when I am ready to come in. It was non-evasive surgery. I stayed over nite and was released the next day. Yes there was post surgery pain but it was gone in a week or so.

No one can tell you when to go. That's your choice. get the second opinion have everything ready..
Hope this helped!