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Pars Fractures Over Time
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- čas přidán 18. 08. 2024
- Brought to you by Dr. John Edwards, neurosurgeon at Summit Brain and Spine, as part of the Summit Medical Institute
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0:00 intro
0:31 pars anatomy
1:15 typical scenario
1:45 why is it bad
2:16 treatment
2:30 surgical management
3:16 conclusion
considering this option dr. have been living with Grade 1 spondylolisthesis of L4 on L5 with pars interarticularis defects of L4. i shyed away from bone fusion as an option but i constantly feel weak, sleeping is always uncomfortable. not sure what to do. im very fit, have tried therapy many times 36 yr old
I was diagnosed with this in 2015 at age 23 L5/S1. At the time I was being scanned for pain that was a kidney stone, so this was discovered unintentionally. Back then I just had minor arthritis aches that got better with rest and ibuprofen or acetaminophen. Over the years as I've aged and furthered into my work career, my quality of life is declining rapidly. I don't have the leg pain thankfully, I just hurt in the low back and spine area. I really don't want a fusion, but I'm struggling. Saw someone at neuro/spine care and was treated like I had no issues and didn't need to do much. Now that I'm 32 and had my entire spine x-rayed, it showed degenerative disc disease, worsened arthritis, thoracic scoliosis and cervical bone spurs. To me this is a lot going on at my age but I feel ignored and stuck right now.
I'm sorry to hear about your experience. Hopefully you can find a good solution
Hey, hope you're well. I'm in the same situation, I was diagnosed with spondylolisthesis with a pars defect, degenerative disc disease and a few mild bulges. I found out about it after a car accident from 5 year ago but apparently it's from my teenage years. The quality of my life has vanished and I just stay at home everyday. I've just turned 29 and the only options i've been given are surgery or to live with the symptoms. I'm in pain everyday without fail, some worse than others, I get numbness waist down and sciatica pain down my right leg. When you hear things like you could end up paralysed or in a wheel chair it just sends your head crazy. Keep positive and hope for the best.
Fracture at pars interarticular at l5
Cool?
I am pending a CT scan to confirm some xray images of pars defect. I am prior military and before that also played sports in high school. At any point then could I have been injured and not know it?
I am now 40, out of the military and have this back pain. The CT scan will confirm it all or atleast begin the next steps.
I live in the uk I’m 37 have grade 1 spondololesethesis and pars fractures. I’ve seen the specialist today and he told me I’m “too old” to have any injections and that surgery won’t work, surgeries are unsuccessful. He basically said that they can’t do anything for me except physio & pain relief. I’ve gone multiple blocks of Pysio and it doesn’t help. Really at my wits end now I’m in so much pain & can’t sleep. If I could afford private treatment I can guarantee I wouldn’t have been told that.
Go else where. Hes wrong
Hiya, I am in UK and I had injections for this at age 53! It cost me £2500 going private :-( On the plus side, I can tell you it's instant pain relief, as in zero pain, immediately after you wake up from the heavy sedation - and you feel strong and superhuman - for about 2 months! On the downside, the pain and problems start coming back again, slowly but surely, and I can assure you I'm back to where I started 2 years on. Surgeon also suggested radioablation surgery, where they basically kill the nerves around the problem area to remove all associated pain permanently. But if you youtube this, there are some specialists out there that are warning that the long-term effects of this 'miracle' cure aren't properly known yet. My surgeon also said a pars repair at my age is unlikely to work because of all the 'scar tissue' that's likely to be in the area, and that in his opinion pars repairs don't work out very well in general and just cause more problems when the pars doesn't heal properly after surgery. I also mentioned spinal fusion like mentioned in this vid, and he told me that it's only worth doing this if you are in constant really bad pain, as the loss of mobility and the accelerated degeneration of the area in older age wasn't worth it; it was his opinion that yes if you've been in a car crash, go for fusion but otherwise don't. Just my 3%. So maybe ask your surgeon about this ablation thing, or fly to the USA where a lot of these new experimental pars repair procedures are being touted - with the caveat that you are already a major shareholder in a gold mine.
What % of your fusion patients have been surveyed 1 year after surgery and say the procedure failed?
Thank you for your comment. You bring up a great topic. We are actively collecting data to monitor fusion rates and patient satisfaction. Hopefully we will be able to present this at a later date.
I've had 2 fusions. Neither of them failed I'm 3 years in. The vertebraes 3-4 down r failing though but that's a separate issue. The fusions have held up well though, even with horseback riding, pregnancy, and being a young mom on a farm 😊
What if you can’t go in anteriorly due to adhesions in the abdomen?
Can it not all be done posteriorly?? Why have 2 incisions to deal with?
There are different advantages to both approaches and each comes with their specific risks and benefits. Something that should be discussed with your provider to determine which would be best for you.
It's a lot easier to put the cages in from the front rather than working around the facets in the back. It really cuts down on surgical time.
Iam 37 years old..I have 1st grade L4/5 lumbar spondylolisthesis due to L4 pars fracture with mild disc changes and dr recomended fusionsurgery
Sympthoms are not much yet
Do u recommend surgery now
Is it the only workable option ?!
Thank you for your comment. The decision to pursue surgery is individualized and is a risk vs benefit analysis. It can be helpful to seek out multiple opinions if you are unsure.
I did the same surgery it’s painful 😖
How painful is it? Is it better now?
It’s painful and very long recovery ❤️🩹 but obviously worse trying if you are always in pain before the surgery pick ur dr wisely it’s very important , have someone help you after surgery and have plenty of rest after surgery for three months. I am feeling better thanks God