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  • lbs07
    Member
    Post count: 3

    football injury june 2012, since MRI & CT in Sept 2012 he has complete interarticularis defect on the right L5, spondylolysis, partial pars defect has developed on the left L5 since prior CT. We have been in a brace most of the last 6 months, we just found out that the he has now left pars defect Feb 2013, he is in a brace as well as a brace that goes to his left knee to keep his left side in place, he is in pain all the time and by looking at the reports he is not getting better he is getting worse….any recommendations? he is only 14 and he has lost all quality of life….

    Donald Corenman, MD, DC
    Moderator
    Post count: 8465

    There is a complete section on adolescents with pars fractures on this website which you are welcome to read. It appears that your son has had good conservative treatment (activity restriction, flexion brace). Using a hip spica brace is really the gold standard “as well as a brace that goes to his left knee to keep his left side in place”

    It is my opinion that with progressive changes in spite of conservative care “he has now left pars defect Feb 2013”, that surgery can be considered to repair the pars fractures. The factors that determine what surgery needs to be considered include disc health (does the disc demonstrate tears on MRI or is it intact), slip amount (is there a step-off and if so, how much?) and the amount of “gap” between the two fractured fragments of the pars.

    You are welcome to contact the office at 888 888-5310 for further information.

    Dr. Corenman

    lbs07
    Member
    Post count: 3

    Dr. Corenman post=3846 wrote: There is a complete section on adolescents with pars fractures on this website which you are welcome to read. It appears that your son has had good conservative treatment (activity restriction, flexion brace). Using a hip spica brace is really the gold standard “as well as a brace that goes to his left knee to keep his left side in place”

    It is my opinion that with progressive changes in spite of conservative care “he has now left pars defect Feb 2013”, that surgery can be considered to repair the pars fractures. The factors that determine what surgery needs to be considered include disc health (does the disc demonstrate tears on MRI or is it intact), slip amount (is there a step-off and if so, how much?) and the amount of “gap” between the two fractured fragments of the pars.

    You are welcome to contact the office at 888 888-5310 for further information.

    Dr. Corenman

    lbs07
    Member
    Post count: 3

    Thank you! I’m going to read the section regarding my sons situation, I don’t understand why the conservative treatment we have went through is not working, it started off on the right side and I assume with the left side taking up the “slack” the left got fragile & broke as well, he has not been in any sports or any activities since June 2012, he is miserable & I am so hurt seeing him in pain, since this left fx, he has been in more pain than ever! We live in Alabama so I don’t know what to do as far as who to see and who to trust with my 14 year olds back! I worked for neurosurgeons for 2 years & they treated him just by looking at his test & assessing him in the office not as a patient b/c they do not see children. I just want my son back, he plays baseball, football & basketball & is very good at all sports! It was our lives & now it’s like he is lost. Thanks again for your response!

    Respectfully
    Lori S

    Donald Corenman, MD, DC
    Moderator
    Post count: 8465

    Conservative treatment (brace and activity restriction) works in only about 50% of patients so this failure of healing is not unexpected. I noted the factors before in my prior response that lead to a good pars surgical repair outcome. If the pars repair is not an acceptable surgical choice or the pars repair surgery is not successful, fusion of the segment leads to a successful outcome (satisfaction and return to sports) about 90% of the time.

    Dr. Corenman

    EBERMAN
    Member
    Post count: 2

    Hi Lori,

    I came across your post about you son back issue. By looking at what he had it very similar what my son experiences now. He is 14 old athlete and wearing brace for last 4 weeks, however so far we do not see any improvement. How is your son’s back doing now since you had this post?

    Thanks.

    –Eugene.

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