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L5-S1 Spondylolisthesis, pars defect...Should I have surgery?

AnonymousUserAAnonymousUser Posts: 49,578
edited 06/11/2012 - 7:25 AM in Back Surgery and Neck Surgery

I am considering having surgery for the conditions outlined in my MRI report: Degenerative Disk disease, Lumbar Stenosis, Grade 1 anterolisthesis of L5 on S1, disk bulge between L5-S1 with disk space desiccation. Evidence of pars defects.

The pain started 6 months ago with a shocking sharp shooting pain from a spot above my left hip in my back; it wouldn't go away. All summer I could barely move.

That's when I started going to doctors....I've already done physical therapy,cortisone epidural shots,and chiropractor visits... which have helped some. The pain seems to have migrated down and center and I'm now having throbbing lower back pain.

An orthopaedic surgeon suggested doing a laminactomy and spinal fusion with screws and rods.

I've read that the fusion helps alleviate leg pain but I don't really have pain down my legs. Mine is mostly in the left buttock and a deep throb in the lower part of my back. I've also read that this surgery does not necessarily cure lower back pain....

Have you had this surgery - or chose not to have this surgery? Can you tell me anything? Would you recommend that I have this surgery or wait some more time and re-evaluate in a few months?


  • Hi Frenchy, I had PLIF for anterolisthesis L4-5 on August 5th. I had hip pain that radiated down my leg. I have had chronic back pain off and on for 20 years, but I had the surgery for the hip pain because it was making me limp. Also, my spondy was unstable. Have you had flexion/extension xrays to check for instability? This was really the deciding factor with my surgery.

    I had done all the conservative treatments of course first. Surgery is really a last resort. There is no quarantee it will help. Also fusion often leads to adjacent disc problems in the future. I still have back pain when I do active things, like clean house or work, but this is nothing new to me. Fortunately my hip pain and limp is gone, so I am glad I did it.

    Perhaps you should seek a second opinion, just to help you feel more confident in your decision. Make sure your surgeon is a spine specialist as well.

    Good luck with your decision. I know it is terrible hard to make. I was unsure all the way into the OR. Now I know I made the right decision. >:D< Cali-Sue
  • I had a two level PLIF in Feb 2008 and I'm glad I did. Even though I still have pain, it is not nearly as bad as it was before the operation.

    I do suggest getting a second opinion. I did and that is what sealed the decision for me.
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  • Hello Miss,

    I had similar condition for ten years and finally gave in to a fusion. I had Isthmic Spondy which is broken pars both sides and DDD. I had a physical job and could endure no longer.
    Now six months on I wish I had done it sooner.
    Find a surgeon you feel confident with. Mine has fixed my back.
    I had a Fusion laminectomy and rhizotomy.
    [The last is when they deaden a few nerves in the area to stop future pain.]
    I am retraining and cant wait to get back to work.
    Do your research and ask yourself how bad is it really,once its fused theres no going back but if thats the way to stop the agony then go for it. Im glad I did.
    All the best
  • Hi Frenchy,

    I had very similiar issues with the pars defect (S1/L5) as well...but had a 2 level fusion w/hw Nov 10.

    My buttocks were always burning and throbbing, I think mostly to the iritation from the PARS. The stenosis and spondy cause L5 to twist and shout! Talk about bone on bone. :O

    A few suggestions:
    1 Give it some time to see if it disapates some..could be 3-9 months (a guess) My LPAR shots and Epid's only lasted 3-6 weeks at best which is a good indication of a real problem. You will know when its time to decide on the surgery

    2 Get a second or third opinion. Docs find different things and angles on the issue.

    3 Get a CAT scan if you haven't already. It clearly found my Pars...that all other docs missed.

    See my recovery thread:


  • Hi, I was wondering if anyone with a Lumbar Pars Fracture, DDD and Spondy, has had their leg give out without warning. I am wearing a Bivalve Brace and experience leg aching in the thigh and calf sometimes in the ankle on the right side. While going up some stairs, on the third step without warning my left leg could not hold my weight and I just puddled on to the step, almost as if I meant to sit there. I am waiting to talk with my Neuro Surgeon but in the meantime I am rather concerned. Any input is really welcomed.
    Newbie here :S
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  • I didn't have a Lumbar Pars fracture or Spondy, but I did have a broad based herniation and DDD and my leg gave out of me quite a bit, can't tell you how many times I came really close to falling on my butt or my face.
  • Only you can decide how much pain you are in and how it affects your lifestyle. If you aren't in danger of permanent nerve damage, there is no problem in waiting. You can always have fusion, but there is no turning back once your spine is altered.

    Keep in mind that surgery will not restore you to the way you were at an earlier point in time. It is primarily performed for pain relief...or in the case of spondy, to protect against further instability.

    It is always a good idea to get several opinions from docs from different medical practices. In addition, I found it useful to consult with both neurosurgeons who specialize in the spine and ortho spinal specialists.

    Fusion usually does very little for back pain. If you don't have leg pain, it sounds like something other than the spondy is causing your back pain.
  • Hi There,
    I am a spondy case, DDD, bilateral pars fractures...my own back got worse and worse, increasing unstable. I could barely walk.
    My surgery came just in time, my spasm's radiated right into my chest like a tight rubber band. The pain insane.
    Sadly, I was troubled with complications but do not regret the decsion at all/ The recovery is slow.
    My own opinion is that, because I had numerous issues that were causing pain problems it has hindered my recovery. I have had to adjust my lifesytle and still hope that in a few years I will be better still.

    Whether to have surgery is always a difficult choice. I would suggest, because of the complications and slow recovery, it must be a "can't cope with this any more" step, unless you have CES or other serious threats going on.

    Good Luck.
  • Hi, I had a 2 level TLIF/Laminectomy on L4-S1 for a recurrent central herniation on L4-5, retrolisthesis L4-5, disc bulge with nerve compression on L5-S1, severe DDD, chronic degenerative endplate changes, and facet arthropathy. I continue to struggle with chronic back pain and nerve damage. Everybody's situation and results can vary, and it's hard to say whether or not one should try surgery. It's a personal decision, but a major one. Read all you can about it and consider the odds of a successful outcome. Whatever you decide to do, I hope that everything turns out in your favor.
  • Kadaro,

    It has been a few months since your surgery how are things going? I am contemplating the same surgery and my biggest concern is how much motion I will lose because of the fusion from s1 to l4. I am 35 years old and used to be very active. I am a cyclists and hiker who used to spend 20 hours a week excercising and competing in events. Does the fusion limit your motion and do you think it would affect my sitting on a racing bike?

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