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Grade One Spondylolisthesis in Adolescent

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:33 AM in Back Surgery and Neck Surgery
I am new to this forum. I am the mother of a 15 year old gymnast with Spondylolisthesis. If there is anyone out there that is in this age group, or parents with a child with this disorder, I would appreciate any information you can share with me.
Is a fusion most likely to succeed if she has stopped growing? How do I know when she has completed growth?

Thank you,



  • Charlotte,

    Welcome - I am a 39 yr old male that has a grade 2 spondy. Both my OS and NS believe my pars defect existed as a child and eventually overtime my L5 disc could not support the vertebra and it herniated. Most of my research about Spondy points to Football Players, Divers and Gymnasts developing the condition - I was a Baseball Pitcher and my NS believes that led to excessive wear and tear. Most of the time this condition does not produce symptoms in young kids - my guess is that this not the case with your daughter and that is why you have an early diognosis. Spine Health is a great site, but I found www.spineuniverse.com to have more helpful info. Because this condition leads to instability of the spine - Fusion is the only fix if the condition is symptomatic - that is according to my surgeon. Hopefully with some good old rest things will improve for your daughter. Unless she is in really bad shape (pain wise) I would not consider Fusion until many other conservative treatments were given a fair shake. I have not had my surgery yet (Aug 24) and I gave conservative treatment a year to work. Hope this helps. Is your daughter in pain? Does she have any disc issues? All the best to you, Mike.
  • Is your daughter in pain? Has she been told she needs surgery? Is she giving up gymnastics?

    Unless her spine is unstable, your daughter will not necessarily need surgery...unless the pain does not respond to other treatments. Sometimes wearing a brace can handle the problem.

    I imagine your pediatrician can give you an idea about when your daughter's growth will be complete.
  • Hi Mike,

    Thank you for your help. I have been researching this for the last week and now have more questions than answers. I had a spinal fusion for a grade one spondylolisthesis 10 years ago. I guess heredity played a part in this.

    Your guess is correct. My daughter has a lot of pain. She needs surgery. She has suffered with this pain for the last 18 months. Walking, and normal activities make it worse. She has upper back pain as well. Her MRI says "There are multiple mature dorsal osteophyes anteriorly. There is a single bulge of disc in the upper dorsal area." Are Osteophytes abnormal for such a young girl? There are disc issues if there is a bulge. What is the importance regarding these findings?
    I will check out spineuniverse.

    Thanks again,

  • Hi Gwennie,

    Thank you for your input. Yes, my daughter is in a lot of pain. It is intermittant, but even if I apply the brakes in the car, the jarring hurts her.
    I don't know if her spine is unstable, doesn't a Grade One Spondylolisthesis mean it is unstable? How can one tell?
    We saw an orthopaedic surgeon who said he would like to do a "Direct Pars Repair" I looked this up and have found conflicting information about this. The main thing is, a direct repair is reserved for low-grade spondylolisthesis above the level of L5. Do you know anything about this?
    She has had to give up gymnastics after attempting to do it for the last two years. She has also had to give up ice skating because of the pain.

    Thanks again,

  • I imagine what you are dealing with is a difference in language. A slip is a generic term that laymen use. We think of it as meaning a slip as in instability. But many times even the higher grade spondylolisthesis is not necessarily unstable. Many people have spondy and never know it until they have an X-ray for another purpose and it is uncovered at that time. I fell into that category! Often a person can have spondy and be asymptomatic.

    That is not the case with your daughter, since she has pain and the pain is apparently the result of the spondy. It seems like it might be a good idea to get a second opinion. You might want to find a pediatric orthopedic spinal specialist to consult with for a
    second opinion.

    In your daughter's case, have you tried all the conservative methods of treatment? If the pars surgery is not recommended at the L5 level, I imagine it is because the L5 segment takes the brunt of all movement and they may fear that it would not hold. But I have heard of others having the pars repaired at L5.

    This particular board does not have a feature where you can ask a doctor a specific question. This is a peer to peer sharing board, but none of us have professional ties to the medical arena.
  • Hi Gwen,

    Wow, I can't imagine a higher grade slip being stable! I don't know much about all of this, but am going to learn!
    What you say about the L5 level and direct repair makes sense.
    I am going to seek two further opinions. I have an appointment at the end of the month with one spinal surgeon and then one is to be arranged with another in the next few weeks.
    The pediatric spinal surgeon I have already seen treats children with scoliosis. I am not sure if he has much experience with spondylolisthesis.
    Thanks again,

  • Charlotte,

    Did they do flexion/extension x-rays? If they did - the surgeon stating there is no slip could really mean the spondy is not moving when bending forward and leaning back. My surgeon told me there is a such thing as stable spondy. I am sorry she has had to stop active sporting activity - that has to be tough for her. How have the other appointments went? All the best, Mike
  • Hi Mike,

    No, they did not do flexion/extension x-rays. I will ask the doctor about the possibility of the stable spondylolisthesis.
    She saw another surgeon and he is going to do a Spect Scan and then we will discuss it further.
    I live in the U.K. and have just found out that there are very few spinal surgeons who specialise solely in spines.

    Thank you,

  • Hi Charlotte,

    I doubt if what I say will be of any help to you but I developed spondy at about the same age as your daughter and I was involved in track and volleyball. I am now 55 and my spondy is considered to be between a level 2 and 3 but it is stable (L5 has slid forward more than 50% off S1). I have had some excrutiating pain with it and some mild pain - depends on the day. I have been saying no for over 30 years to a lumbar fusion. Unfortunately I don't know if I should have had it done or not. I do know that a good chiropractor has made a big difference for me. But as I got older I developed a lot of problems with my cervical and thoracic spine. I often wonder if that was because I 'protected' my lumbar spine by using my arms and upper back for things. There is no way to know.

    The medical field has improved greatly in the 30 years since I was first diagnosed so find a really good spine doctor and listen to his/her opinion but ask LOTS of questions.

    I sympathize so much with you and your daughter and I know that I am no help to you in this huge decision that you need to make. My fears for her would be: 1) if she has the surgery will it lead to more surgery because I have always been told that having a fusion would put more pressure on L4 and the vertebrae above which could cause problems with it/them, and 2) if she doesn't have the surgery will she some day have the problems I have now?

    I wish you and your daughter the best.
  • Hi Jennie,

    What caused all of your spine problems? How are you now? I hope you are doing well.
    I feel sorry for you to have had to go through more surgery because of the complications. How did you find your surgeon?
    I am afraid for her to have surgery because it may lead to more surgery as you said and the increased likelihood of the surgery putting more pressure on the other levels in her spine.
    It is such a major decision. I think surgery is the last option.

    Thanks for your input.

  • Hi Charlie,

    The doctors have never been able to tell me for sure why I have had so many spine problems. I did fall from the second floor as a young child and that could have caused some damage that wasn't noticed until I got a little older (my parents didn't have much money and assumed I would be fine without medical attention). I have what is called isthmic spondylolisthesis because the pars interarticularis is fractured allowing the slippage to occur. The doctors don't really know if the fall might have something to do with it, or if it was because I was athletic, or it could possibly just be a genetic weakness.

    Thank you for asking how I am doing. I am getting better but still incredibly weak - doesn't take much to wear me out. I am supposed to return to work in a week but I am going to ask my doctor for an extension of my disability leave. I hope he understands; if not I will probably fall asleep at my desk!

    My surgeon was recommended to me by my family doctor. I have a fantastic chiropractor also and I asked him what he knew of the surgeon and he had a lot of faith in him. He said he was an excellent surgeon and was not the kind to recommend surgery if he thought there would be any other options. I live in Columbus OH and so I have access to a lot of good medical people in the immediate area.

    It must be very difficult for you as a parent to have to face this decision. In my heart (as a mom) I feel that what you said is good - surgery is the last option. But I also know that eveyone is different and situations are different and only YOU, with guidance from your doctor, can make the right decision for you and your daughter. I think you are a great mom who is looking for the best course of action to help your daughter and she is a very lucky young lady.

    Best wishes to you and your family.

  • Hi Jennie,

    My daughter has an isthmic spondylolisthesis like you. It is a Grade One.
    I am glad you have a lot of faith in your surgeon. I hope you are ready to go back to work soon. Don't go until you recover completely.

    I'm the lucky one to have a daughter like mine!

    Take Care,

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