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Pars defect

I'm 20 years old and recently (3 months ago) had an x-ray due to back pain that states "there is a pars defect at L5-S1 level with anterolisthesis of L5 over S1 by up to 8mm".

The doctor basically described it to me as a my L5 vertebrae is slipped over my S1 by 8 mm and that most likely it developed earlier in life as my bones grew. I was never a very active child, no sports, never in a vehicle accident, never any problems with my back and never no need of x-rays until 3 months ago. However I've worked as a Personal Care Attendant for the past two years. Very physically demanding at times, involving 12 hours on your feet, heavy lifting, pulling, etc. I am still currently working on lighter duties (still suffering with light duties), however I am also under workers compensation as an "aggravation of pre-existing condition".

I never questioned much, until I recently seen an orthopedic doctor who mentioned the 'pars defect' and explained it and from my understanding it is a fracture in my pars. However he also said it probably developed when I was younger.

Everywhere I look it up, it says that most cases these fractures are usually stress fractures and that caused the slippage. Unless I understood it wrong, I believe this is more work related rather then something I've had for years. I have a lot of symptoms: constant aching, worsening when I'm more on the go going from aching to pain, pain/aches start to travel to my hips and legs, also my legs feel very weak at times (luckily hasn't completely gave out yet). Sitting for longer then 20 mins hurts, sitting to standing aches, interrupts/stops me from sleeping most nights, and I also have muscle spasms all throughout my back most days. I'm always uncomfortable and feel like it's interfering with my daily life which is causing my mood to get down a lot.

I just wanted to know if anyone has the same problem, or could explain it a bit more to me. What grade is 8 mm considered? What is a pars defect? Is it more likely to be work related? and anyone have any suggestions to ease the pain?
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  • LizLiz Posts: 7,910
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    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • Sounds like you are trying to figure out how much workers comp is responsible for.... I have no experience with this, but I'd think you could contact your human resources and at least start there.
    33yo mom of two. My surgical history...preadolescence scoliosis, kyphosis, and a hot mess.... 5 spine surgeries and lots of items added I wasn't born with (titanium, peek, surgical steel). Guess cremation is out. TSA loves me.
  • LJS-29LLJS-29 Posts: 3
    edited 06/10/2013 - 2:54 PM
    Thanks, and yeah, right now my biggest frustration besides constant pain, is to figure out how much work is responsible. But My human resources manager was one of the ones who tried to keep me at work on 'light duties'. It's a private company, so you know what they are like, all about money. Cheaper to keep me at work then have me off. I don't see my managers much, so to them I look fine, they don't understand the pain I'm in. Even my co-workers can tell when I'm having a bad flare up because I'm on the floor with them for 8hrs whereas, I see my manager at the beginning of my shift and that's it.

    My workers comp case manager only just found out that I was never diagnose with this (or never had the need of a xray) in the past. He said from his understanding I was diagnose before and because it turns out I wasn't diagnose until 3 months ago when I first felt it , my case will have to be re-investigated.

    I just don't completely understand what a "pars defect" really is.
  • I suggest you google it and look on youtube, there are lots of available videos on youtube. Again, I have no experience with workers comp, but I do hope you can get quality treatment and are able to get pain relief and stay at work. I personally think working as much/long as possible (without causing further injury obviously) is the best for most (and again I'll say most) spine patients... working keeps our mind off the pain, keeps us more fit than sitting at home and greatly reduces depression (in my opinion)...Obviously its best for your company to keep you at work, but try to think about how it would be positive for you as well to stay at work. In the best case, hopefully you can get some quality treatment for the pain and stay on light duty while you are healing. Best of luck to you!
    33yo mom of two. My surgical history...preadolescence scoliosis, kyphosis, and a hot mess.... 5 spine surgeries and lots of items added I wasn't born with (titanium, peek, surgical steel). Guess cremation is out. TSA loves me.
  • Hey There-

    I am 25 and recently out of a L5/S1 spinal fusion for a pars defect, herniated disc, degenerative disc disease and stenosis! I just wanted to say hi, and see if you had any questions about my experience (a very positive one)! As far as the fracture, I was also told that it was either present from birth, happened as I was growing or even at a young age I had an injury that never was treated. If you look up 'pars defect' you can see where the fracture is, my X-Rays never showed this! I suffered with this pain for 3 years before finally getting an MRI and finding out the details of what was wrong. As far as 8mm, that is the degree of slippage of the disc. Here's a bit of my story- I was told as a teenager that I had a slipped disc- chiropractors said 'no big deal'. Then, 4 years ago I was rear-ended really bad and that is when the pain went down my legs and I saw the chiropractor again who just said the disc slipped more and was then pressing on my nerve-- sciatica. I got frustrated with wasting money for no relief and ended up suing the girl who rear-ended me. When I finally got a true diagnosis, I was told that since the 'pars defect' was there it was a pre-existing condition that allowed the disc to herniate when she rear-ended me. Since it was a pre-existing condition, I didn't get much $$ from that lawsuit! :( However, that may not be the case for everyone- and I am not sure how worker's comp will handle it. Keep us updated, and let me know if you have any questions!
    Olivia Douglass
    MIS TLIF L5/S1 on 5/1/13
  • Welcome to Spine Health.

    I had a lumbar fusion and decompression for a spondylolisthesis at L4/5. Mine was a grade 2 slippage. They usually use a grading system to explain the size of the slip. An 8mm slip doesn't mean much unless you know the size of your vertebrae.

    A 'pars defect' is a weakness in the pars which can cause pain in itself. Because of the weakness, you are liable to getting a stress fracture there, and if the pars on either side are fractured then the vertebrae are able to slip forward or backward. That can cause awful pain and sciatica.

    I didn't have my lumbar fusion until I was in my 50s, but I was told that I would have had the problem since I was a child or early teens. The doctors were amazed that I had carried 3 pregnancies without being diagnosed. The growing bump during a pregnancy is known to pull the vertebra forward and compress the nerves even more. I did have a lot of back pain and sciatica while I was pregnant but I thought back pain in pregnancy was normal.

    I hope that you will find some help soon.
    Do ask any other questions that you have and we will try to share our experiences. Please be aware that we are not medically trained and can only share from what we have been told and experienced.

  • You actually made me understand the pars defect a lot better. You also made me feel better about the pregnancies. I am only young and I do want children. Even though that might be another 2-3 years down the road, I started to worry about how a pregnancy might affect my back (plus I'm not very big anyways, 115 pds, 5'1)

    Nothing as really changed, my Mri came back good, there isn't any tissue damage or nerves involved, so surgery isn't a rush, it all depends on the pain now. and the slippage hasn't worsen, which I thought it might where I'm still working a fair bit. I find it difficult with work, and just daily living actually. Good and bad days also, depending on how much I can relax. I find it hard lifting and bending mostly. I dreads to go grocery shopping or even switching my laundry.

    My emotions are still up and down as well, on my bad days I get upset or depressed almost because I feel like I can't do a lot of the things I want/need to do because I get pain. But I try to get out as much as I can when then pains bearable or even just sit around with friends so I don't get too depressed.

    Both doctor and physio said that they are looking at long term for me, and to stabilize/reduce the symptoms I should start to look at another career, which is what I expected anyways. So now I have to start thinking seriously about going back to school and finding something that would agree with my back.

    thanks everyone! Your all actually answering my questions better then the doctors I've seen hah.
  • mustangkinseymustangkinsey South CarolinaPosts: 8
    I don't remember the extent of mine but I have the same thing and they want me to have surgery I was curious how your case turned out?
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