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L5/S1 Pars Fracture Sugery??

Started by Bobby32C on 11/09/2010 11:46am

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

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RichardT please give update. I believe my son needs direct pars repair

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Please direct our family to surgeon who specializes in direct pars repair for 17 year old male athlete with bilateral L5 pars defect with only very slight spondylolisthesis but constant pain x11 months. Has had to give up senior varsity basketball mid-season. Serious disappointment to put it mildly. Need help finding right doctor. We live in Texas but would travel almost anywhere.

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I had an ALIF at L5-S1 about 2 1/2 years ago and was very happy with the service I received at GW Hospital in DC. I saw Dr. Joseph O'Brienhttp://www.gwdocs.com/orthopaedic-surgery/joseph-o%27brien

It is a rough and long recovery, but worth it in the end. I had extreme pain before surgery and tried everything before I decided to go through with it. I would recommend it to anyone who is living with such intense and chronic pain!

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My son suffered from severe pain for 2-3 years and we finally found a knowledgeable surgeon who has experience with Pars and performed Pars Defect Repair surgery which was a complete success. Most surgeons don't have enough experience to give you the right advice. We lived that for 3 years and traveled to so called experts. There is a waiting list but I cannot say enough about the physician that gave my son and our family our lives back. I want to pay it forward so I am happy to help anyway I can. Let me know how I can help. I don't think I can name the surgeon on the forum.

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if you can travel to the Uk then you should see Professor John dowell at Springfield hospital Chelmsford Essex . He has experience of direct pars repair with titanium screw fixation and bone graft also known as a buck repair. It is the best option especially for young athlete

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I recommend contact Professor John Dowell at Springfield Hospital, Chelmsford, Essex UK as he is highly experienced at operating sportsmen and older patients. A direct pars repair (Bucks) can relieve pain and return function.

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I'm were your at i be been dealing with it for 3 years and just found out what was really wrong I have pars defect in s1/l5 and there hasent been a day in 3 years that I have been pain free. But knowing now what it is I just got my first injection where the defect is and well its only day one but I was able for the first time in 3 years to do my dishes without taking a break. But my advice would be try injections first before surgery because if that works u save yourself less recovery time and less pain. Its not a guarantee it will work but I was willing to try this before surgery. Good luck!!!

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I'm were your at i be been dealing with it for 3 years and just found out what was really wrong I have pars defect in s1/l5 and there hasent been a day in 3 years that I have been pain free. But knowing now what it is I just got my first injection where the defect is and well its only day one but I was able for the first time in 3 years to do my dishes without taking a break. But my advice would be try injections first before surgery because if that works u save yourself less recovery time and less pain. Its not a guarantee it will work but I was willing to try this before surgery. Good luck!!!

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I was a competitive athlete throughout my youth and into university. At about 14 I suffered the first effects of my pars defect. It went undiagnosed and untreated for my entire life. It may or may not have cost me athletic scholarships among other things, but it certainly took months and months away from my training at a crucial time in my life. I eventually returned to athletics after about six months off only to reinjure my back within a few weeks. Another six months off, barely being able to walk. I had x-rays, no one saw the pars fractures. I managed to walk on to a division 1 school and still play for two years, but the pain became unbearable and I had to give up. I ended up obtaining a degree in biomedical engineering with a focus on biomechanics, particularly in the spine. After years away from sports, I finally went back to competition in my 30's. I was in great shape, working out with weights for years before making the leap. I made it about five years before re-aggravating the injury. I am now told by every spine surgeon I have seen that I need a fusion because my spondy has progressed to far to do a direct repair. In the course of my research I have discovered that there are many surgeons out there who will do a direct repair. As a result of my education, I have had the opportunity to meet with many of them in the UK and the US.

There is a vast misunderstanding of this condition. Most orthopedists, surgeons, trainers, physical therapists, and chiropractors will tell you that it is nothing to worry about. You will live a normal life, just take some time off of activity. Well, I can tell you that I have not lived a normal life. I have had excruciating back pain off and on since I was 14 years old. I wish that my parents and I had been given the option of a direct pars repair then so that I would not be suffering now...less than 40, in decent physical shape, and needing a fusion surgery. Yes, you or your child may feel better after a few months of rest, but these fractures do not heal on their own. I have done the research, it is less than 10% that will heal on their own. If they don't heal, then they will continue to be re-aggravated over and over, and eventually one vertebrae will slide forward over the other and you will be worse off than you are now...and needing a fusion like me. I know that I would choose a minimally invasive direct repair in a heartbeat over a fusion. Get educated on the condition and the treatment options, don't listen to doctors who tell you that this injury will go away. I can only tell you from my experience that it does not go away unless it is repaired. There are surgical options now that can be done in an outpatient setting. They do not require huge incisions and tons of hardware to be implanted.

As I mentioned I have found many surgeons who will do this procedure and who believe in the benefits of it. I am not clear on the rules of this forum and if I can direct anyone to particular surgeons, but I wish I was given the option to do this when I was younger. You may still find that you or your child is not a good candidate for this procedure, but you should hear this from a surgeon who is also willing to do a direct pars repair. If they say it is not right, then you can feel more comfortable in your decision to try to treat it another way. Please let me know if there is anyway I can help by providing guidance or advice. I am not a clinician, but I do have a strong background in spinal biomechanics and I have a particular passion for those with pars defects because it has affected me for such a large portion of my life.

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My teenage son has been in pain daily for almost three years from a bilateral pars fracture. The surgeons my son has seen have suggested he try steroid injections (might save him some time until he's a little older for surgery...he's 16) but my son does not want a "bandaid" for his injury, he wants it fixed.
Through my online research I've come across direct pars repair as a possible option.
I asked the the most recent surgeon whether he had performed this type of surgery and he said he had done about a dozen.
As a mom contemplating back surgery for their child, a dozen just doesn't sound like a big enough number. From what I understand the surgeon must have a "practiced hand" as this type of surgery requires a great deal of skill.
So I'm hoping that someone might be able to help me. I'm looking for a surgeon in the NY/NJ area that has performed direct pars repair with great success.
I know someone mentioned they had their direct repair done at HSS... I would love to know with which surgeon and how are you doing today?
It's so hard to see your child hurting . It really tears me apart inside.

Thank you for your time.
Be well,
Julia

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Hi bobby I am not to new at this surgery stuff when it comes to spinal surgery i had my first one close to 8 years ago , fusion with 8 screws and rods. my back had been broke since i was 19 i had three jobs and i dealt with the pain, And then last year my back broke and busted a vertbra in half and cushion and bone into my spinal chord, that was worst pain i had ever felt in my life. i would go to my doctor he would give me a shot in the hip about everyday i would walk in he would get rite to me , he knew i was in severe pain. no one around where i live wanted to repair it so i traveled back to michigan had my surgeon fix it, The exrays and mri didnt show any fractures, so it was a surprise to him when they wacked me open, so now theres a plate in there screws and all. Pretty much solid bone its not easy somedays i have auritius and bone issues when its cold out i am miserable. but i will say this i couldnt stand the siatic pain and mine is trying to go away, but sometimes i feel it. so its no peaches and cream. my pain is so much less. so i guess if you want it to get worse it will. without the surgery, I have found relief with my own tense machine. kept me off of pain meds, i do have gabition 800mg if i need it. so good luck on your des, no one knows how much pain your in. so you are the one that has to put up with the pain. i have put up with mine for over 40 years. makes for a un happy life and it plays a toll on your family, I am now by my self and i believe that my pain had lots to do with it. so good luck take care.

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Hi RIchardT and everyone,

Richard, I took your advice and made contact with the Professor that you mentioned last year.

I have a bilateral pars defect of my L5/S1 which has been giving me so much pain for the past 20 years. At 46 years of age I decided enough was enough, I simply cannot accept this pain which was ruining the quality of my life so I went to see the Professor. He has suggested I have the Buck Direct Repair to stabilise my spondylolysis at S1/L5 followed by a decompression and discectomy to correct my disc bulge in the same region.

I have my surgery scheduled for 13th September 2016 at the Springfield Hospital, Chelmsford, UK and have managed to take a lot of time off from work to recover.

Can I say, your explanation of your experience alleviated my anxiety of having the surgery and for that I would like to thank you. Naturally, I will everyone informed of the success and recovery, but thank you Richard for sharing your experience.

Regards
Adnaan

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I'm very glad to have found this thread. I also have a bilateral L5 pars defect with slight anterolisthesis. I was wondering if all of you had a herniated disc at L5-S1? I didn't think having a pars defect caused the pain because I've had it all my life and only when I got a disc herniated did it start causing me troubles. The doctor suggested fusion, but I was just curious if anyone knew of the direct pars repair procedure is being done in Utah? Is this an alternative to the fusion procedure when the disc is herniated at L5-S1?
Thanks again everyone for your stories and experience.

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hi bobby yes its a decision that only you can make. my back has broke two times now. and I have had two surgeries , first time it broke I fell from a roof, I put up with the pain for forty years it just got worse, they put in 8 screws first time and took and fused together my entire lumbar is fused now my cushions in my neck are bad. when u have these surgeries your going to be giving up lots of stuff, but if your in mountains of pain does it really matter. I am having issues with the siatic nerve in left leg. its getting some better. I am not suppose to bend si I try hard not to bend. cant lift over ten pounds. and if I don't then I pay for it with pain and plenty of it. this is a slow healing process, it takes plenty of time. I hope for the best for you
, happy healing.

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Adnaan,

Did you end up having the direct repair on your pars defect? If so, how did it go?

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Hi, all--We see this thread is a few years old, but we'd like to share some information we recently published about pars fractures. This article was written by one of our Editorial Board members who is an expert in surgically treating this condition: ( Spondylolisthesis and Pars Fractures ).

We hope this information is helpful to future visitors!

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@Bobby32C @Maggie Thank you so much for all the details and info, the info relieve me of a lot of stress and anxiety.

I am a male, 30, and am very athletic, love to drive, take part in adventure sports, run marathons etc.

I recently got diagnosed for Grade 1 spondylolisthesis of l5 on s1 with bilateral pars defects. Also L4/L5 bone spur with foraminal stenosis

I am in touch with the Laser and Spine Institute who is suggesting me to go for a Buck surgery to realign my L5 that would apparently solve most of the problems that cause severe lower back pain, sitting down and performing any activity. I really need your comments / views on this, as you must be aware I am a little nervous and anxious considering surgery

Thanks

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My daughter is 15 and in severe pain! Please update this thread on any advise. She can’t sit, stand long... I fear surgery!

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To LynnT, and her daughter. I had an accident when I was 19 and damaged my lower back and what I call my tail skid. I lived with it for 19 years before I had surgery, when complications forced it. While this may seem to be a long time to wait, it has been plenty early in my life as I have had an add on fusion since. I had more than 10 years magic living mainly like a normal person following the original surgery.
What did I learn? Surgery is great, but has long term limitations. The hardest part other than the pain, and later the complications, is getting employment. You need the right job and employers are very sceptical of people with back injuries. Exercise is the best way to help your back and for me that was mainly swimming, a kilometre before breakfast three mornings a week. The medication for the pain can have consequences and now I have problems. A supportive and loving family is the medicine, especially if they can do it unobtrusively. She will need space to deal the the pain and limitations this puts on her life.
I hope this is some use to you. Also tell her to not have a second accident like I did after my add on fusion, that really complicates life. Best of luck and chin up, God bless you.

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Hello guys,

I am a 29 year old male from the Uk.
I have recently been diagnosed with bi lateral pars defect of l5.
As expected i have done plenty of online reading and have managed to scare myself silly.
I am of course worried that i will no longer be able to continue my currently very active lifestyle.

I did get a glimmer of hope by reading about the pars repair treatment that was undergone by @scottHews, @RichardT and @Adnaan. i would be so very grateful if any of you three (or anyone else who has had the procedure or knows of anyone that has) could update me on their progress and success following the procedure.

thank you all in advance,

Edd

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Hi RichardT, I’ve been looking for a surgeon in the uk to perform this procedure as John Dowell has now retired, can I ask how you feel 6 years later and if you’d be able to play any type of sport without restriction, I know it’s 6 years ago but trying to find some hope.

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Hi Ed Vickers, have you had any joy in finding anyone who does this procedure yet? I emailed Scott Hews a few weeks ago and he’s still doing fine, I’ve been searching week after week for a name of a surgeon who does this procedure, one surgeon said it’s only for people under 19yrs old, even though we know Scott Hews was 43 when he had the surgery, which is my age now, I’m desperate to be playing squash and living a normal life but it’s almost like this procedure doesn’t exist anymore, HCA claim to do direct pars repair but can’t get the name of a surgeon from them as John Dowell has now retired. Let me know if you get anywhere.

Regards
BLathan

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Blathan, hope you’re well. Drop me an email edd.vickers@rectory.co.uk.
I’ve had a couple of names that seem promising but haven’t pursued yet.
Edd

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I am looking for anyone you does direct repair of a pars defect. I see that there was a doctor in the uk, John Dowell, that was mentioned but it seems like he had retired. If anyone could give me any information on a doctor to contact for direct repair of a pars defect please let me know.

I am a college basketball player who is going to lose every year of eligibility because of this nagging injury that causes me pain every second of everyday. I am on 19 and I have been injured since I was 17, this is no way to spend the young years of my life. Please if anyone can contact me at kailenthibodeaux@yahoo.com please do. I will go anywhere to get out of this pain.

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I am in need of direct pars defect repair. If anyone can give me any information on a doctor that performs this procedure please let me know. I see that there was a doctor in the Uk that performed this procedure, but it seems like he has retired. I was injured when I was 17 and I am still injured at the age of 19. I was a competitive basketball player that even received a scholarship at the college level. Unfortunately I have missed my freshman and sophomore year because of this nagging injury. It has takin my dreams away from me, now I only want to be pain free for a chance to live my young years of life without any pain. Please if anyone has information on a doctor that directly repairs pars defects please email me at kailenthibodeaux@yahoo.com

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If anyone can give me any information about a doctor that performs direct repair of a pars defect please let me know. I want to continue playing college basketball ball and not let my dreams die away. If anyone knows please contact me Kailenthibodeaux@yahoo

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I'm dying every day of pain. I can't walk, sit, work, or anything. I'm suffering from L5 pars fracture and need a surgeon's name to help me as I read that Prof. John Dowell has retired. please, if you can, help me, please send me: Ahmedosman6523@gmail.com

Someone help a soul from dying painfully.

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I know it’s been 10 years since you posted this. I myself just got an X-ray that shows pars defect and my chiropractor suggested I do an MRI as well. I’m not having any back pain right now but I have had awful bouts of lower back pain for the last 10-15 years. Did you end up deciding on surgery or did you go the natural route?

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Hi,

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