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Pars Defect- Spondylolysis -

Hi. So I have spondylolysis- also know as a pars defect, in the L5/S1 along with a minimal grade 1 spondylothesis of l5 over S1 by 2 mm, but doctors said it shouldn’t be that that’s causing me pain. They all pretty much agree that it's the spondylolysis.

It started about seven months ago. I was exercising, doing squats, and my back was generally hurting, but that not that bad. And it was all over the back, not just in one spot. Then I saw a chiropractor, and I believe he exacerbated the fracture and pushed it over the edge. After seeing him, the pain was unbearable, and it has been since. The greatest amount of pain comes from sitting down. Once the pain starts, it increase the longer I’m sitting, or if I’m standing for too long. Once the pain gets really bad, it stays that way for a while. So if I do something to aggravate it- mostly sitting too long- the pain is constant, whether I’m laying down, standing, whatever. No pain in the leg. Little in the butt sometimes.

I've tried medications. Neurotoin, meloxicam, Valium, hydrocodone, norco, steroids. Back brace, microcurrent, physical therapy, facet injections. Nothing has worked.

I'm 35 and the doctors say to avoid a fusion at all costs. But no alternatives have worked. And they haven't provided many alternatives. They also mentioned a direct pars repair, but said it's very tricky procedure and typically done on adolescents. 

So my major problem is sitting, but I have researched and never found anything that said sitting was a problem with spondylolysis. Which makes me wary of fusion or anything else.

So my questions are this.

Could it be anything besides spondylolysis?

How do these things typically progress? It's been almost seven months with minimal improvement. 

How do you know you're going to the best doctor out there? Want to make sure a top-notch doctor does the surgery. I'm in Los Angeles and it's hard to tell.

Should I get the fusion? I hear so many horror stories and am just hoping this gets better. The pain is unbearable.

Thank you in advance for any response.



  • dilaurodilauro ConnecticutPosts: 13,526

    I assume you had mri's to diagnose your condition.   What does your doctor suggest in terms of any action plan for you?    I have to assume because you have a grade 1 spondylothesis  , which is the lowest degree and mildest condition.  Based on that surgery is not required to correct that condition.

    But since you said your pain is unbearable, perhaps there is something else going on.   Have you discussed your pain level with your doctor and if so, what do they contribute it to?

    I was a bit concerned over your statement

    SCOTTBURS said:
    I've tried medications. Neurotoin, meloxicam, Valium, hydrocodone, norco, steroids. Back brace, microcurrent, physical therapy, facet injections. Nothing has worked.
       When you said nothing has worked, what were your expectations of these medications and conservative treatments?

    It also sounds like you want to rush in to surgery, looking for the best surgeon in the LA area.  Before you jump into that, I think it would be in your best interest to have a complete diagnosis of your situation.  Is it more than the grade 1 spondylothesis ?   Just doesnt make a lot of sense , considering that condition and the amount of pain you say you are in.

    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
  • Hi Scottbrus'  I have spondylolisthesis L4 and L5 and L5 on S1

    grade 1. The major problem is with standing. pain goes way when sitting or laying down.

    Pain starts with 5 minutes of standing.

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