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pars defect in lumbar spine

AnonymousUserAAnonymousUser Posts: 49,625
edited 06/11/2012 - 7:25 AM in Spinal Stenosis
:H Hi, I've just seen my neurosurgeon with a diagnosis of a pars defect and spinal stenosis in the lumbar spine L4.L5 and S1, she has prescribed Nurontin and a bivalve brace. Has anyone had any experience with this treatment? Has it helped, or has anyone had the spinal fusion? I'd be greatful for anyone's experience or knowledge about this condition.
Thanks,
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Comments

  • Hi N2, welcome to SH. This is a great site full of information and support. I had bilateral pars defects of L4 causing spondylolisthesis of L4 on L5. I did conservative treatment for 2 years but never a brace. I have heard of someone being given a brace for pars defects/spondy in teenagers with sudden onset pars fractures, usually after a sports injury. This can immobilize the spine while the pars heals. I don't know if your situation is anything like that. Is the brace for stabilization, pain relief, does the doctor think it may heal, or ? Do you have a spondy also? I am 41, was 39 when I was diagnosed, but had back problems since age 17 when I jumped off a counter. I believe that is probably when I fractured the pars. Then it just took time, added weight and 20 years of being an RN to make the pars defects result in the spondy, giving me back pain and radiculopathy.

    I had a fusion in August of L4/5. I am doing pretty good. Will return to work next Friday. For lots of fusion stories look at the surgery thread.

    Good-luck to you, let us know how it goes with your treatment. >:D< Cali-Sue
  • Hi Cali-Sue, thanks for sharing with me. I had a cervical corepectomy of the C5,C6,C7 in 2000, the Neuro Surgeon said I have the bones of an infant in my spine (tiny) I have DDD but the bones are degenerating. When I had my cervical procedure she said I had some thorasic involvement but couldn't do all that at one time. A few months ago my right leg started aching and I thought it was from walking in a circular pool all summer to lose weight, then this diagnosis and an MRI confirmed Pars defect I don't believe the surgeon thinks it will get better, I think she wants me in the brace till the pain is unbearable. To me this takes a big chance that I will lose more feeling or damage the nerves that scares me. It seems to me surgery could correct this (maybe) and I can lead a normal life. The guy doing the brace said if the brace relieves the pain that would be a good indicator that surgery will be successful.
    I am very depressed so I hope I will be able to at least exercise with the brace (walk, treadmill) to lose some weight and then maybe surgery will be an option. I have to do some research on Spondy, I'm not sure if I have that.
    Thanks so much for your info.
    Write soon if you like.
  • I'm not sure I know what you had done as I am new to all this, are you glad you did the surgery? How are you now?
    N2waterdogs
  • I also have pars along with disc degeneration and both spondlyolesthesis and spondlyosis. I had an accident on Valentine's Day and havent been the same since. I am in excrutiating pain and have no idea which way to turn next.
    Does anyone have any advice they can share with me?
  • Over a year in the pain you speak!!! I am done. I have had 6 epidural/facet injections and 1 Rhazotomy. Tons of PT in and out of the pool! The pool therapy is the best! But, no real relief. After research and talking to Ortho and Nuero surgeons a fusion is the best fix. Your choice is what kind. I am going for the new one. Trans 1 or also called Axial LIF. Recovery much less!!!! Only few docs do this. You can go on the company web site and they will send you info. It was very helpful! I am so ready!

    All choices come in your time. I wish you time!
    Blessings
    Backtyme
  • Hi Back Tyme,
    We seem to have the exact same problem. I've noticed that the Drs. advocate surgery for the younger folks but I am 57 and they don't seem to anxious to do the operations. I recieved my Bivalve brace last Friday and it's now Wednesday x-mas eve day and I can see right now this cannot be a forever option for me. When are you going to have your procedure? I wish you luck with it and please let me know how you are. I'll be sending prayers your way.
    God BLess
    E :H O:)
  • I don't know if my case is a help or not but i was born with pars defect in L4, L5, and L6 but i also have an extra vertebre which is L7 and doctors cant explain how or why i am able to walk but they think that it is because my L7 stabilizes my spine. Doctors can't explain how, why or how long i will be able to walk but right now i am 34 and still walking. My vertebre move slightly when i over exert my self and i can feel that they have moved the next day because i have a high tollerance to pain i don't feel this right away. This happens rarely like once or twice in a 5yr period, or if i fall the wrong way then it takes me a couple of weeks to recooperate then i'm ok again but during that period i need pain pills and to watch how i move during this period and my spine moves back into place by itself. Doctors tell me that this is herittary and about 5yrs ago my mother found out that she has it. Then we realized that my grandfather had it had a accident at work and then they fused his back and he lived in pain for the duration of his life.
  • I had an x-ray done awhile ago and in it, it revealed I had Pars Defect but instead of my Dr actually doing anything to fix the problem I was prescribed pain pills for about 4 yrs. I now have a new DR and he wants to me go see a Neurologist and says I will probably have to have surgery which really scares me because I have a 4 yr old who is constantly on the go. When you have surgery how long are you laid up for and what all is done?
  • I have been having the worst back pain ever, done a couple MRIs, they found DDD, and a couple other minor things, but were saying that the pain I was having just didn't add up to just the DDD, so I went to a Neurosurgeon and he said the same thing then sent me down the hall yesterday ( 03-01-11 ) to have xrays with me bending over slightly and then with me arching back slightly, the same day I was called and said I have PARS, now they are talking surgery. I would do anything to get out of this daily pain. It is every single day, constant! I have a 4 yr old and a 5 yr old, how long will I be down? I just don't know what I'm going to do. I have a husband who will help with everything as much as he can but he works a full time job. After his vacation time is used up I don't know what I will do. SO I was wondering how long I will be down. Anyone have any advice r been through this that can help me out?
    Thanks so much
    Amanda
  • I'm going through the exact same thing, I have a 4 yr old & a 5 yr old. :(
  • I'm going through the exact same thing, I have a 4 yr old & a 5 yr old. :(
  • After years of wondering and 5 different doctors I finally was diagnosed with a PARS defect in L5 to S1. I began having pain a few days a month at age 22 to it being most of the month by the time I was 28. I decided to do the surgery because of all the missed diagnosis it had gotten to the point where there were no more options available. When the doctor opened me up he said it was apparent the fusion of L5 to S1 wasn't enough so he fused L4, L5, and S1. Other than that small hiccup, the surgery went great and I was in the hospital for 4 days. I felt great when I got home, even to the point that after the 4th day home I was walking 4 miles without stopping!!! I had never felt better, even my parents had said that they had never heard me talk so much in the past 2 years combined. The surgery was July 1st and I was amazed at the results until mid September, that's when the problems began. One day all of a sudden I had soreness that was more annoying than painful but the next morning it turned to pain and hasn't stopped since. I am in double the pain that I was before the surgery and I didn't have leg pain before the surgery but now it's quite common for me to have pulsating pain down the side of my leg and I ALWAYS have pain in my lower back into my buttock. The lower back pain is constant and to best describe it is exactly like a TOOTHACHE in my back. I've been to numerous doctors and they all refuse to touch me because of my age or they don't seem to want to follow up after another doctor(my original surgeon moved a month after my surgery). I have spent 31 months in pain management and medication and there isn't any plans to move forward with any other procedures. They seem to be out of options, this is such a horrible position to be in. I would advice you to seriously take every avenue before bowing down to surgery. My pain has been constant and not gotten any worse since September 2008 but unfortunately I remain in constant pain. Please remember that once you get the surgery then it's forever, they can go back in and undo by taking out the hardware but usually the damage has been done. I though I understood what I was getting myself into pre-surgery but I was wrong so please think long and hard. Another discouraging aspect is that every doctor I have seen have said how good of a job my surgeon did and I agree and still trust that doctors abilities. So no matter how perfect of a job that your doctor may be able to accomplish, it may still not be a success. I hope I have not scared anyone because it has the potential to be WONDERFUL as I felt for the first 6 weeks out of surgery but it also has the potential to be a disaster as I have lived with since September 2008. Good luck and god bless!!!
  • being in highschool and having a pars defect is not good for the patient..i've suffered with this stupid thing almost my whole life and just want an answer that is straight forward..CAN A PARS DEFECT BE CURED PERMANENTLY?
  • I suggest that you read as much as you can about pars defect and spondylolisthesis. Have they said what grade the slip is?

    I had a fusion and decompression on L4/L5 last March for my grade 2 spondylolisthesis. I am very much better now and the awful sciatic pain in my legs and lower back pain is practically gone. I am in a position where I am able to do most things again. :-)

    Because of the slip of my vertebra, I needed the back of my spine removed to take the pressure off the cord, which was under severe stenosis. I also had the disc completely removed and replaced with 2 cages filled with the bone that was removed from my spine. The facet joints also had to be undercut to take the pressure off the nerve roots.(All these were part of the decompression)

    As far as my recovery went, it wasn't as bad as I had anticipated. My husband was home for 3 weeks and I needed a lot of help, even with personal care for the first couple of weeks, but then I gradually managed to do more. After surgery, most surgeons will tell you that you mustn't bend, lift anything very much, or twist. (No BLT) I would also say that reaching up or to the side is also painful.

    The fact that your children are 4 and 5 is better than a toddler or baby who needs to be picked up.

    There is a lot of helpful information about how to prepare yourself and home for fusion surgery and also items that will really help you while you are recovering.

    If you want more information, please do ask and feel free to send me a personal message (PM).

  • andy113 said:
    being in highschool and having a pars defect is not good for the patient..i've suffered with this stupid thing almost my whole life and just want an answer that is straight forward..CAN A PARS DEFECT BE CURED PERMANENTLY?
    I have had mine since high school. I am 40 now and still in pain. Waiting for appt. in June with ortho spine surgeon.

    I was never totally pain free but I did enjoy light activities...but nothing too rigorous...but I also have a grade 2 spondy and a few other things.

    I heard talk of a woman in our church with a pars fracture who healed with a rigid brace..but she didn't have bilateral. A friend's child has it and the brace worn for a yr did not help it.
  • My diagnoses is a minor spina bifida occulta deformity of S1 with no other spinal abnormalities; does anyone know what the surgical treatment for this involve (the S1 doesn't meet in the middle). While my pain isn't yet excruciating, It's constant and my main fear is that it will become so (It's becoming harder and harder to simply sit in a chair, and the diagnoses seems to stem into other leg and back and neck muscular pains as a result).
    So what i was wondering is do they just connect the S1 at the middle and I walk away? (My Spine is still in a normal condition)>
    SO my question is; DOES ANYONE KNOW THE SURGICAL TREATMENT for S1 !!?
  • My diagnoses is a minor spina bifida occulta deformity of S1 with no other spinal abnormalities; does anyone know what the surgical treatment for this involve (the S1 doesn't meet in the middle). While my pain isn't yet excruciating, It's constant and my main fear is that it will become so (It's becoming harder and harder to simply sit in a chair, and the diagnoses seems to stem into other leg and back and neck muscular pains as a result).
    So what i was wondering is do they just connect the S1 at the middle and I walk away? (My Spine is still in a normal condition)>
    SO my question is; DOES ANYONE KNOW THE SURGICAL TREATMENT for S1 !!?
  • Please make your own post as this post is from a former member and will be missed if you need answers....

    Go to left hand column of this page to where it says under---> MY stuff about half way down-Forum topic or Create content and make your own post so you can get attention.
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • I am soooo glad I found this place as I am frustrated and a little ticked off. I just cant get any direct answers. A little background. About a year ago I started having really bad lower back pain so my PC sent me to have and MRI, CAT scan,Bone density scan and xrays. The MRI showed Lumbar Spondylosis, and pars defect as well as Osteoperosis. I have seen all kinds of doctors, and finally went to a spine surgeon a couple of weeks ago to discuss surgery. He informed me that my bones are to weak to do surgery. He informed me he would have to use screws or a rod and he was certain if he tried to fuse them they would crack. I am in so much pain, and have just recently been diagnosed with Fibromyalgia. Needless to say I am looking for some alternatives to back surgery I guess. They did a discogram too that how they found the disks. Any Any help you can give me I would so appreciate. I am desperate. Michelle
  • My friend is going to have surgery early part of July and was wondering if anyone has had surgery from both the front and back at the same time in repairing his back. He is in so much pain and has just had a new artificial knee done in early part of this year 2011. They are going to fuse him at L5 and S1. Any help to ease his mind would be greatly appreciated. He is not on any pain medicine but can barely walk without being in constant pain. No doctor has offered any pain management just this surgery and he's almost 60 years old.
  • Hello I posted resently and I am new to this sight..in Feb 2011 I was diagnosed with spondylolisthesis (mri says grade 1 - xray says grade2) who do i believe?? It says on the report I have that three views of the lumbar spine sho a grade 2 (this is reading fom x-ray)spondylolisthesis of L5 on S1. Bilateral pars defects are present. Volume loss in the endplates at L5 are present. The upper lumbar interspaces and vertebral are inteact...can u explain this to me plz? the pain dr just told me yes it shows u have 2 pinched nerves and nothing else has been said...i have had 3 epidual steroid shots..and the last month 3 selectice nerve root blocks..the pain is worse than before I started all this...he told me yesterday he was referring me to a surgerion...should I be this scared?? thank for your help:)
  • Hello everybody,

    I fall from the stairs before 5 months and that s when my story started.First I was sent to do MRI of cervical,thoracic and lumbar spine.Cervical spine C4-5 bulging discs,thoracic spine normal and lumbar spine L4-5 degenerative disc disease.My symptoms neck pain,headaches,back pain,pain in legs numbness and cramps also,I was barelly walking.I couldn t walk too much or seat too much.My doctor sent me to pain managment where the doctor gave me epidural injection in lumbar spine what caused me greater pain and after 3 days I end up in emergency room almost paralyzed.After that pain managment doc.order me again for MRI which showed C5-6 hemangioma,with straightening of cervical spine reflecting muscle spasm,L4-5 showing dorsal annular tear and a broad mild disc protrusion.disc material extends in right neural foramen narrowing the anterior inferior aspect of the right neural foramen to a mild degree.After that pain managment doc.said he isn t giving me anymore the injections.I was reffered to Memorial Hospital what was my biggest mistake from neurologist since my emg was normal and Mri s not.I came to Memorial and they put me in the room with director of neurosurgery who said that he saw my cd s of mri s and he doesn t see nothing.After physical exam he said that something is wrong with me and he will reffer me to my doctor.I had to pay them copay and they charge my insurance for nothing but I m disputing that charge like my insurance.Beware of that,don t go there for help because they wan t help you.After all of that I read on the internet about the Bonati spine institute so I decided to go there because my condition was not getting better.In Bonati they done evaluation and orthopaedic surgeon talk with me explaining that I have the fracture and that he will try to do proccedure which is called ablation billateral pars fracture on L5-S1.I agree to go on the surgery because it s done with local anesthesia and with laser.After surgery I felt relief,no pain in legs I thought that s it,but one week later again my symptoms are here so my primary doc.send me to CT scan of lumbar spine.CT scan show L5-S1 billateral L5 pars defect and sacralization of L5 with no spondylolisthesis. :jawdrop: :OO I still have appt.with surgeon from Bonati spine institute for one month,he said if the first surgery doesn t help than we will proceed to 2nd.I m totally lost,don t know what to do anymore,I m not going anymore on surgery that s for sure.I have 3 different opinions none of them didn t help,I know this sounds like that show Mystery diagnosis but I m wondering where to find a specialist in the spine area who will diagnose me with right condition.I apprecciate any help,thank You :/
  • im 30 years old and was hurt by a teacher when in high school for not doing something he asked. i said no, so he pushed me to the ground, my legs went one way, my body the other. i now have a pars defect, which i was put in a brace for 2 years to try and heal. i also have 3 ruptured discs, disc degeneration and ankylosing spondylitis. L2 L3 L4 L5
    i have not had, nor will i ever have surgery. i am treated with gabapentin, endep, naprosyn and morphine sulphate as well as morphine skin patches. this enables me to lead a good life. prior to being medicated i spent most of my teenage life in and out of hospital. my specialist finally got my drug combo and levels right, now i can live my life. i can only drive an auto car, cant walk long distances and cant stand for long. however, im happy with that as it beats being bed ridden like i was before. i have been told it would be too dangerous to have a child as my back would get so much worse and i would have to stop the meds due to birth defects. i desperatly want a baby but im not sure what to do. im leaning towards giving it a go but i am scared. has anyone else been in this position?? i also have barely any sensation in my lower legs, no reflexes and numb feet. also, my pars defect keeps on reopening. what do i do? any advice??? is it so wrong to want a child? i have a loving and supporting partner who is prepared to take a year off work to help with the baby if we have one, and also a very supportive family. is it worth the risk? and the pain?? im scared to go back to how i was before the meds but mostly im scared of what will happen to my spine during pregnancy.
  • I understand You because I m 30 years old more than anything I would like to have kids,but every doctor that I seen said NO because my back are to damaged,I had surgery,going on 2nd surgery.I am out of myself,I spoke with my husband and I am afraid that he is going to leave me because I will not be able to have children.I mention even adoption,he doesn t even want to hear about it,not to mention that we are sleeping in separate bedrooms,fighting all the time regarding that subject children.I am stress out about whole this situation,I love kids more than anything and this is such tragedy for me not to have my own child so I do understand what You going thru.Wish You well!
  • Hi,

    I too have degeneration (we probably don't have to worry too much about that one b/c everyone has it to some degree and will get worse as everyone ages, annoying that they always seem to point that one out. even though everyone has it), L-5 fracture with slippage that keeps getting worse, ruptured and herniated discs, along with siatica.

    I am currently on a seemingly never ending PT treatment plan, and meds. I always had a high pain tolerance, but once it got so bad I couldn't stand up in the mornings or sit for more than an hour, I had to get help.

    Problem was that all Dr.s wanted to do was inject, then tell me that was all they could do. No one even seemed to care to address the pars defect (I'd seen a top spinal surgeon in my state). Only after a visit to an ER (when I was in so much pain I couldn't work) did they notice on the X-ray my pars-defect and tell me to, once again see a spine specialist. He wanted to do surgery. The more I researched it, the worse surgery seemed though.

    Basically, after seeing two useless surgeons that would give me one bottle of Norco then treat me like a junkie afterwards if I still needed meds. I resigned myself to a life of constant pain and just decided I'd do my best to live life. I married and got pregnant right away. I didn't ever ask a doctor if I should, since I never managed to find one that seemed to care. My family was really concerned though. It was agonizing and painful. My OB realized how bad off I was and gave me two Rx for 20 norco during my 2nd trimester. After my first son was born, I finally on the recomendation of a friend saw a pain doc. He got me on pain meds norco and oxycodone and did a nerve oblation. I felt some relief, (I'm guessing from disc related pain), but the majority of my pain is still there. I've now been seeing my pain Dr. for about 5 years. I decided that I was willing to go through the pain again so my son could have a sibling. With the approval of my OB I continued on my pain meds (I chose to only use the lesser of the two Norco, but later found that it was a class C for pregnancy where as the oxy is only a B...go figure!). My Dr. said that the meds that I was on were not associated with birth defects. The only (known) issue was withdrawl symptons by the baby at birth if enough of the medication is taken later in the pregnancy. I was very conservative with my medication intake during pregnancy. My Dr. told me though that the risks to the baby would be higher if I was in unbarable pain though. Since I do have a high pain tolerance, (I was going running and hiking with a knee injury for weeks that my Dr. told me most people wouldn't even be walking on), I wanted to keep the levels of medication in my system low enough that the baby would suffer no ill effects. He was born totally healthy with no withdrawl symptoms what-so-ever.
    Being pregnant with these issues was really painful, at times (especailly towards the end) I though I was going to lose my mind. It was worth it though for me.
    If you are going to consider having kids, some things I would do are:
    Find an OB ahead of time and address all of your medical issues and make sure that they will partner with your pain Dr. to manage your pain. You don't want to wind up pregnant and find out that your OB refuses to agree to allow your pain Dr. to perscribe pain meds.
    Before you get pregnant, get on meds that you can take while pregnant. It very well may be a sacrafice as you already found a combo that works well for you. You do not want the stress of switching to dealing with a higher level of pain while you are newly pregnant and though I'm not familure with all of your meds, since you say they cause defects you'd want to not be taking them while you try to get pregnant. Even after switching keep in mind you will be in more pain as the pregnancy progresses.
    If you are not already doing physical therapy, start and let them know that you are planning on getting pregnant. You need to make sure that your body/back is in as good of shape as possible.

    I hope some of this helps,
    good luck!
  • Hi,

    I too have degeneration (we probably don't have to worry too much about that one b/c everyone has it to some degree and will get worse as everyone ages, annoying that they always seem to point that one out. even though everyone has it), L-5 fracture with slippage that keeps getting worse, ruptured and herniated discs, along with siatica.

    I am currently on a seemingly never ending PT treatment plan, and meds. I always had a high pain tolerance, but once it got so bad I couldn't stand up in the mornings or sit for more than an hour, I had to get help.

    Problem was that all Dr.s wanted to do was inject, then tell me that was all they could do. No one even seemed to care to address the pars defect (I'd seen a top spinal surgeon in my state). Only after a visit to an ER (when I was in so much pain I couldn't work) did they notice on the X-ray my pars-defect and tell me to, once again see a spine specialist. He wanted to do surgery. The more I researched it, the worse surgery seemed though.

    Basically, after seeing two useless surgeons that would give me one bottle of Norco then treat me like a junkie afterwards if I still needed meds. I resigned myself to a life of constant pain and just decided I'd do my best to live life. I married and got pregnant right away. I didn't ever ask a doctor if I should, since I never managed to find one that seemed to care. My family was really concerned though. It was agonizing and painful. My OB realized how bad off I was and gave me two Rx for 20 norco during my 2nd trimester. After my first son was born, I finally on the recomendation of a friend saw a pain doc. He got me on pain meds norco and oxycodone and did a nerve oblation. I felt some relief, (I'm guessing from disc related pain), but the majority of my pain is still there. I've now been seeing my pain Dr. for about 5 years. I decided that I was willing to go through the pain again so my son could have a sibling. With the approval of my OB I continued on my pain meds (I chose to only use the lesser of the two Norco, but later found that it was a class C for pregnancy where as the oxy is only a B...go figure!). My Dr. said that the meds that I was on were not associated with birth defects. The only (known) issue was withdrawl symptons by the baby at birth if enough of the medication is taken later in the pregnancy. I was very conservative with my medication intake during pregnancy. My Dr. told me though that the risks to the baby would be higher if I was in unbarable pain though. Since I do have a high pain tolerance, (I was going running and hiking with a knee injury for weeks that my Dr. told me most people wouldn't even be walking on), I wanted to keep the levels of medication in my system low enough that the baby would suffer no ill effects. He was born totally healthy with no withdrawl symptoms what-so-ever.
    Being pregnant with these issues was really painful, at times (especailly towards the end) I though I was going to lose my mind. It was worth it though for me.
    If you are going to consider having kids, some things I would do are:
    Find an OB ahead of time and address all of your medical issues and make sure that they will partner with your pain Dr. to manage your pain. You don't want to wind up pregnant and find out that your OB refuses to agree to allow your pain Dr. to perscribe pain meds.
    Before you get pregnant, get on meds that you can take while pregnant. It very well may be a sacrafice as you already found a combo that works well for you. You do not want the stress of switching to dealing with a higher level of pain while you are newly pregnant and though I'm not familure with all of your meds, since you say they cause defects you'd want to not be taking them while you try to get pregnant. Even after switching keep in mind you will be in more pain as the pregnancy progresses.
    If you are not already doing physical therapy, start and let them know that you are planning on getting pregnant. You need to make sure that your body/back is in as good of shape as possible.

    I hope some of this helps,
    good luck!
  • Hi sorry to hear of your situation , I have had a spinal fusion L3-L4-L5 which has been a great success 9 years ago at age 45 . My condition was multiple Pars Defects & Spondylolisthesis grade 5 which became a major problem after a side on vehicle collision . I was very fortunate as I had an excellent surgeon who also had to deal with my faulty bone enzyme problem which meant that my own bone was not suitable for grafting . My advise for what it is worth is to make sure your surgeon has a lot of experience in spinal fusion & has the respect of his own colleagues and do exactly as you are told in the recovery phase & hopefully you'll have the success that I have had
    All the best & good luck
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