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Pars Defect Repair Surgery


I am an 18 year old female who was diagnosed with a bilateral pars defect on both L4 and L5 around 2 years ago. Since then, I have tried all treatments - chiropractor, epidural injections, cortisone injections, physical therapy, losing weight, core exercises and all narcotics that are out there. Nothing has seemed to give me the tiniest bit of relief, which leaves me with one last option - surgery. I was never an active person (e.g. into sports), but my back pain has constantly been a bother that comes in waves that results in weak legs and sharp pain in my hips. I was told about a direct repair surgery that would entail screws and hooks to be put into place in order to hold the fracture together but not permanently fuse it - my doctor feels as if this is the best option as I am so young and really not active at all.

I am here to look for some opinions before looking into this surgery further. Has anyone had this surgery done and had relief? I know that it is very painful to have done, but my worst fear is that this will give me even more pain than what I have as of right now. I would love to have something done for my back to finally give me relief.



  • tkdttkd Posts: 53
    edited 08/01/2017 - 3:27 AM

    Hi owllover  like the username. Sorry tohear that you are in pain.

    Did your tests report anything else going on.  Have the vertebrae moved out of position, are nerves or spinal cord impacted. What kind of tests, standing and bending x-ray.  Check for stability.

    I had a grade 1 spondy which became unstable once i herniated the disc.

    When you talk to your doctor ask what he would recommend if you were active, just because you aren't now doesn't mean you won't be later.....I was most active from mid 20s to late 40s.

    Take care,.

  • Hi, owllover. I just had pars repair surgery myself on the 19th of July. (3 weeks ago) mine was fractured at L5 just on the left side. My surgeon used the same technique you described with the Pedicle screw and hook. The surgical pain is the worst part, it starts to get better from 2 weeks on. He told me it would be 6-8 weeks before you really start to feel any better. 

    As long as your disc is still in good shape and you don't have much slip or instability, the direct repair of the pars is what you want. 

    Before surgery I had injections of local anesthetic directly into the fracture to confirm it  was my pain generator. I've also had MRI, Ct scan, and flexion ext. X-rays for instability. I also tried physical therapy, injections, rest, and home exercises. Nothing worked as why I opted for surgery. 

    My first follow up is September 1st. I'm anxious to meet with the dr and see new X-rays. If you have any more questions I will be glad to answer them 

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  • I'm checking back in at 8 weeks post op. At my 6 week follow up my surgeon said the xray looked great. Everything looked exactly how it should.    ( hardware still in place and fracture under compression).  A lot of my muscle and surgerical pain has subsided. Back muscles still fatigue pretty quick in my opinion. At this point My biggest complaint is the super deep ache and discomfort I'm having from what I'm assuming is the bone fracture itself and the healing process. My doctor told me that should really start to get better around my 3 month follow up. I have only been taking Tylenol and muscle relaxers from 2 weeks post op until now. Time will tell, I'll check back in at my 3 month follow up hopefully with less discomfort! 

  • My now 17 year old had same surgery in March. She was a pole vaulter - and had so much pain going down her legs prior to surgery.  Immediately following surgery the pain down her legs disappeared.  However, physical therapy has not seem to help the localized pain in her back.  She had a bi lateral stress fracture but we were hoping 6 months out she would be be feeling a bit better than she is.  Any one have any experience with the localized pain and if this is normal?  PT has decided to stop seeing her until after her 6 month check up her in two weeks since she is not making any progress.  She is getting a little discouraged so I'm looking for some insight from any veterans that have beeen there done that.  

  • Hi kbwmyers, i still have a lot of discomfort and a really deep ache in there. I'm 3 months post op today. My surgical and incision pain is all gone, just feel a constant pressure and ache going on. My doctor says this is normal and should get better with time and healing. Was your daughters procedure open or minimally invasive? I have about a 4 inch scar down my lower back as a result. Took a solid 2 months for me for the muscles to have really settled down... and I've walked everyday religiously. I hope your daughters pain and discomfort gets better as I do mine as well. Take care - jeremy

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  • Jeremy,

    Hope you are continuing to experience relief and it is getting better every day.  She also has a 4 inch scar down her lower back.  The surgery was indeed a success as the major issues she was having prior to surgery is gone but she plateau'd.  Unfortunately for my daughter we are heading for a CTscan in another two weeks.   The surgeon is afraid scar tissue is the issue, but needs to confirm that.  She is very frustrated since we are post 8 months surgery.      She can't bend her knees past her hips when laying flat and can't been more than halfway down to touch her toes.    The surgeon was not happy with her results and wants to get her back to being active quickly.  We just don't know what it will involve at this point.  Thanks for your note. Kathy

  • HELD underage......Liz

    Hi, I’ve had the surgery you’re talking about. I’m 17 and had a pars defect at L3. In March of this year I had a pars repair. I’m now about 8 months post op and have had no relief in my pain. At first the surgery seemed successful, but gradually the pain started coming back. I’m now at the same pain level before the surgery. I’ve had steroid injections in my SI joint, I’ve done physical therapy and pain meds have not helped. This was my second surgery after an L5-S1 fusion in December of 2015. The pars repair was significantly less painful for me after surgery than the fusion. I have about a 4 inch scar in the middle of my lower back. Hopefully this information helps you! 

  • I just wanted to touch base and update you on my daughter and see how you are making out.    My daughter had the bucks hook screw surgery in march of 2017.  It has been a long year but one looking back at it was totally worth.  One side healed really well after surgery but the other was slow to heal and fused back together.  We had to proceed with a bone simulator in Dec- Feb and increased her for vitamin D and Calcium but the follow up ct scan in late Feb showed the bones were starting to fused together.   We followed up with a pain management specialist since she was still at a level three though to just make sure there wasn't some other issues.   He confirmed that her remaining pain was from the slow healing process and it would be slowly get better.    After now two more months we can confirm that pain level has receded to a level 2 and only when she doesn't use the correct form.  Sometimes she doesn't have pain at all.  He even told her that come summer she might be able to start slowly jogging.  She has even started riding her horse and has absolutely no pain riding at all.    We are just absolutely thrilled with her progress.  It has taken a whole year but for us it was totally worth it.   I am feel confident sending my daughter off to college knowing she won't be suffering from severe back pain or having her legs give out because they are going numb.   

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