There is a current thread on this very topic now called “pars fractures”. You can look for that thread on the forum and a very thorough discussion has been made. The short answer is that the PLIF procedure (similar to the TLIF procedure) is generally superior to the ALIF procedure as there is less potential for complications (in the right hands).
The sterility issue has to do with damage to the sympathetic nerves in the L5-S1 level at the front of the spine. Damage to these nerves causes something called “retrograde ejaculation”. This means that ejaculate will exit into the bladder rather then exit out the end of the penis. This condition is estimated to occur in 3-5% of anterior surgeries in the male.
I like the PLIF or TLIF procedure for isthmic spondylolisthesis.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
