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advice please: Chronic L5 Pars/spondilolisthesis of L5/S1

charliebeeccharliebee Posts: 2
edited 06/11/2012 - 8:54 AM in New Member Introductions
Hello, i am writing on behalf of my husband.
My husband was injured in Afghanistan a year ago. We recieved his medical notes from a CT scan he had initially after injury and the notes on spinal area say he has Chronic L5 pars defects with Grade 1 spondilolisthesis of L5/S1.
He landed on his back when thrown by blast and had high level of bruising to coccyx area following debridement surgery to left buttock to remove some of the shrapnel.
He was told the pain in his lower back was caused by nerval damage and would heal in time and also classed him of having "back pain syndrome". The pars/spondilisthesis has only come to light from us getting hold of medical record ourselves.
My question is; is it possible the impact/blast caused him to be symptomatic? He has never had lower back pain ever before and very fit and healthy.
I just wonder why the military have not informed my husband of this medical finding. Currently trying to fight a medical discharge, but i would really be grateful for all your help and advice on this matter. We have only seen the notes today. Thank you. Kind regards.


  • You can get some good information here by putting "pars defect" and "spondylolithesis" in the search box. Does he still have ongoing problems? If he is still suffering back problems, regardless of what developmental or pre-existing "abnormality" was present, that doesn't necessary guarantee he would have had back pain or problems had it not been for the blast, or may not have had issues for decades down the road versus in the present. Yes, its likely the trauma did cause the symptoms, but upon discovery of this condition, there can be an argument for avoiding physically arduous tasks in the future, and hence the medical discharge.
    Did he receive immediate attention for the back injury following the blast, or did he wait for his deployment to be completed to seek care stateside? Is he still in he process of receiving care for this injury, or is he in a "holding pattern" so to speak? Is his ability to seek medical care limited to base, or can he use Tricare to see civilian specialists?
    I don't think you will find disagreement from military physicians that any ongoing back pain was at least worsened from the blast; the problem is you have to either accept their assessment and care, which yes can lead to the medical discharge, or if you are denying grounds for a medical discharge, you are also denying the back problem still exists. Even if he is well now, they can argue that to avoid further injury to his back given his "pars defect" and "spondylethesis", he should be granted a medical discharge.
    There is a process in the military system (aka "comp. & pen" or "compensation and pension") for disability due to injury sustained on duty following medical discharge; its very time-consuming and drawn out before you see a check, given the amount of injuries from OIF and OEF. But it does supposedly happen eventually.
    You will find on reviewing this site when searching out the source for back pain having one "abnormal finding" on one imaging test, doesn't mean that's the cause of the pain...often many tests are requirement and again results must be taken in context of his ongoing symptoms. And if you don't find the exact cause of the pain the efforts may be futile in addressing treatment for the symptoms. Coccyx problems can be difficult to assess, I had a physical therapist with expertise in spine PT that actually did make sure that wasn't an issue of mine, but I will say it was a rather "personal" exam!
    Nerve damage that is a year old is going to be difficult to treat, even if the cause of the original nerve damage is "fixed" or "healed", chronic pain pathways can be established so that the pain persists long after the problem resolves. Kind of surprised to hear he was told this, given it was pain experts within military medicine this past decade that were considered to be at the frontier of modern pain management theory, and in particular hitting pain hard early in the course of trauma to prevent those chronic pain pathways from being established, that's why medics in the combat field actually can carry and dispense morphine. That's carried over to civilian medicine, with more FP's and GP's being willing to prescribe a short course of narcotics in addition to muscle relaxers and NSAIDs immediately following a significant trauma.
    There's a couple servicemen on the site here that might be able to chirp in here about how they were able to find good care within the military system; it does exist, just not everywhere.
    Regarding fighting medical discharge, that may be tough, esp. given that there is already a medical basis to avoid rigorous activity, as necessary in combat, for future depolyment. The government is looking to "trim down" certain branches now, esp. Marines and AF, whereas they are still trying to recruit into other branches, such as National Guard. They may just be looking at "medical discharge" as an out, or they may see his back injury and predisposing condition as a liability to future service. Is he able to perform his prior duties as before, or is he limited in activity by pain? Even when "back to normal", they could argue upon finding this problem, that his body may not be up to the physical demands of a servicemen.
  • Thanks for your imput...
    My husband is getting a possible MD for other injuries which will make him phsically unable for life. We are not bothered about compensation/discharge for pension... we've been through enough to know whats important ~
    was just wanting info on the lower back really... as, it was the least of his injuries; i think it was put to aside to concentrate on the other injuries. He was very fit and able before; had not even visited the doctors in 10 years. thank you.
  • hi and welocme to the forum! :H we are here to offer you support and answer what questions we can. your husband is so very lucky to have such a supportive wife.. i also want to thank your husband for his service.. i wish i had more to offer but i just really wanted to say hi! please make yourself at home and have a good look around at the different forums.. please feel free to stop by anytime.. remember to take care of yourself as well. good luck in seeking help with your husband's pain issues! Jenny :)
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