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Pars Edema, spondylolisis, grade 2 spondylothesis, DDD at L5 S1

littleonellittleone Posts: 77
edited 12/02/2014 - 7:40 PM in Lower Back Pain
hello everyone. thank you for the forum. I'm not looking for advice, or interpretation of an MRI. just looking for others experience who have been in a similar situation.

I'm a 36 year old mum of a wonderful 2 year old. as you can see from the thread title my lower back is a mess. I have also recently been diagnosed with scoliosis at L5 S1 too. I've had ongoing back issues for years, but things really came to a head in January of 2013. since then, I've seen a spine surgeon (orthopedic fellowship trained), attempted a chiro, who viewed my MRI and said no way, PT x2, and pain management strictly for injections. last injection was 10/29. absolutely no relief, almost feel as if it were made worse. (I had a medial branch block).

for the past two years I've been battling back pain with radiating pain into both legs. worse on the right side. it's been managed with injections, and tramadol.

on 11/20, I had a frightening new painful symptom. my legs were incredibly painful, and felt as if they were weighted down. I could not walk. The back pain which resulted was excruciating. on 11/21, I was feeling a bit better, and drove myself to the follow up appt. with my PM doc. explained to him my pain. he was a little alarmed. went and viewed my MRI, came back and told me he remembered my back. told me I have a severe curve to my lumbar spine, virtually no disc at L5 S1 "hone grinding on bone" were his exact words. upon physical exam, I had trouble getting on my tiptoes, and could not go up on my heels. I would not let him twist me. way too painful.

he ordered MRI and follow up ASAP. went for MRI on Sunday. follow up next Monday.
so, had a brief respite with pain for that weekend. on Wednesday I spent four hours or so cooking in preparation for thanksgiving. woke up thanksgiving day unable to move. pain a 9/10. (back pain). this pain has continued and is still out of control. spent everyday since thanksgiving on the couch. getting up to move every 20-30 minutes.
called my pcp on Friday who assisted with some meds to get through the weekend as PM was closed. PCP made me promise to be seen at PM this week. (my PM is on vacation till Monday).

saw an alternate PM doc today who told me I have bone marrow edema, which is causing a flattening of the thecal sac. told me under no uncertain terms am I to do anything strenuous. I am to rest, go to pain management PT with TENS, take a six day course of prednisone. follow up with my PM doc on Monday.

I'm going out of my mind with pain. my husband and I decided together it's not safe for me to be driving. I've lost total feeling in my legs and dropped to the ground a few times. once when holding our son. (back in October.)

so I have some questions:

has anyone ever heard of bone marrow edema with a pars defect? what is that?

have you ever been on a short course of pred for inflammation in the back? (steroids make me mental. I'm nervous)

what is a TENS unit? is it worth it?

I'm so fed up with living like this. my quality of life is shot. I can't stand for more than five minutes without having to sit due to pain. I'm ready for a permanent fix - no more bandaids. sorry for being so long winded, and whining. thanks for sticking with me this long. I appreciate any and all advice or stories of similar experiences.


  • LizLiz Posts: 7,832

    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • Hi Littleone,

    I am so sorry you are experiencing this pain. I can only share some of my experience with hope it gives you some additional information although, I'm not too certain it will give you all the answers you are seeking. :)

    I have a bilateral pars defect at L5. Mine was suddenly taken from a fracture to clear break in December of last year. I tried everything. The steroid dose pack did not do anything to take down my inflammation....however, I was dealing with a full on vertebrae beak (which no on knew of until the doctor went in there for surgery). The steroids really did not do anything crazy to me with respect to side effects. I HATE taking medications of any kind and I was nervous, however, I was quite surprised with the lack of side effects. I do know that everyone is different and others have experienced side effects, I just personally did not.

    I am 9 months post surgery and still have edema that is not going away--or I should say--going away painfully slowly--from the surgery sight healing. I took steroids for about 3 months at one point after surgery which took down some of the swelling but not all of that. My understanding is that edema is swelling if that helps with your question above.

    I have never used a tens machine but what I can tell you is that I was completely bed-ridden prior to my surgery to repair my pars defect. While my surgery recovery is painfully slow, I do know that the bone itself has healed, my issue is purely surgical sight slow healing. I guess my point it, if I had not had surgery, I would have continued to be bed-ridden. I tried 4 rounds of epi shots, PT, a back brace, and I personally just needed to fix the problem.

    If you have more questions about pars defects or anything or just need someone to talk to, please PM me and I will do whatever I can to help!
    Bilateral pars defect L5
  • thank you for sharing your story Kcates. May I ask what kind of surgery you had?

    I am confused. I have been told since february 2013 that I had an old fracture in the pars, probably occurred in my teens sometime. Then the PM dr. yesterday told me I had all of this swelling, which was a precursor to a break in the bone. He told me to be extremely careful, as if the break happened, my spondylothesis was going to slip a whole lot more
    So, is a fracture not a break? ( I am so confused. Every doctor gives me a little bit more info, and I get overwhelmed and never ask the right questions).

    I am to the point of being bed ridden. I went to work today, and after 3 hours at a desk had to call my husband to pick me up. I can't get comfortable. I haven't slept more than an hour or two in days. (weeks?)

    Thank you for your advice and story. I don't feel so alone. This is a black hole. I've dealt with depression before, and see how sufferers of CP land there. I went from a very active life, to nothing. I'm usually a very positive person, too!
  • I will do my best to share some information on pars defects. I was voracious for information once I was properly diagnosed.

    Here goes:

    I also was told that I most likely had pars defect since adolescence or possibly even birth. Most people with the defect do not experience symptoms. I was one of those people until my fracture, and to answer your question, a fracture is not a break, was broken. So if your doctor is telling you that you possibly may break your pars bone and need to be careful, then please heed his or her advice.... it is not fun once broken!!!!! Pain is horrible.

    But I digress, I had the pars defect that became a break, however I did not have the slip of the spine, or spondylolisthesis like you have. My surgeon explained that if I had a slip, I would have had to have a fusion surgery in order to create stability to the spine and then fuse the pars bone back together. Since I had no slip, my doctor performed a more specialized surgery called "direct repair of the pars". He made ~4.5 inch incision and took bone graft from my left iliac crest, placed into the breaks, then wrapped it up with titanium wire. My fusion of the bone has been successful, as I mentioned above, I am having edema due to surgical site healing issues. I am very sympathetic to your situation as I was very active, training for marathons and working out five days a week. I was reduced to laying on my back 23 hours a day. Slowly things are getting better....the pain prior to surgery is gone, I just have a different kind of pain now.

    Are you seeing a spinal specialist? I highly recommend that you meet with one if you are not. I saw five doctors that diagnosed me incorrectly until I sought out a spinal specialist that was fellowship trained.

    I hope this helps but please let me know if you have additional questions and I will try to assist. Also, I recommend looking up spondylosis and spondylolisthesis on this website, I think it may help clarify a few things for you.

    I am thinking of you and truly understand what you are going through.

    Bilateral pars defect L5
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