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  • cotymorris
    Member
    Post count: 14

    I play football, WR to be specific. I was running routes around Jan. 21st. went through the route tree once on each side fine. Came back later that day and did it again, but I felt a shape pain in my low back on the left side. Went a week without doing anything. On the 28th of Jan. I played in a flag game. The first bit I was fine, but later the pain became unbearable. It was clear that I did something serious. I rested it up for several weeks. I then felt somewhat good again, to where I could tolerate it. I got some training in and then it switched sides (from left to right) Again I rested. Then around 2+ months into this deal I go to the chiropractor. He said I have one leg slightly longer than the other and in a few adjustments I should be back to a active life. I thought to myself everyone has 2 different sized legs by some measurement. He did a “side poster hip/si adjustment” Later that day I notice a crazy amount of low back pain, my hamstring has been super tight. I have no medical insurance, but had a MRI, CT scan done. I have a left side 6mm and right side 2mm acute pars fracture with edema. I was wondering what I can expect and what I can do? Will this heal on its own? And will I be able to play sports again? Also could a bone stimulator heal this? Thanks

    Donald Corenman, MD, DC
    Moderator
    Post count: 8378

    You need to state your age but I assume it is in the 18-26 range. These pars fractures have most likely been present for some time (normally occurring between 8 and 15 years of age) and your athletic endeavors have most likely caused a tear in the pannus (see website under isthmic spondylolisthesis).

    Typically, these pars fractures will not heal on their own. There is an algorithm regarding treatment (see pars fractures on website). A bone stimulator will not heal the fractures.

    There is a very small chance that these are new fractures and that a brace will heal them. How to interpret if these are new or not depends upon whether there is a slip present, the disc has tears or is degenerative, how big the gap between the fracture fragments is and what the fracture ends look like on CT scan.

    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.
    cotymorris
    Member
    Post count: 14

    Yes I’m 20. They said no slip. No soft tissue damage was noted.
    Can I send you a copy of my scans? What about playing football in the future?

    Thanks

    Donald Corenman, MD, DC
    Moderator
    Post count: 8378

    When you say no soft tissue damage, does the disc on MRI look pristine? On a flexion X-ray of the lumbar spine, is there no slip at all on the film?

    If the disc is perfect and there is no slip, you have some options. You can live with this and most likely have occasional exacerbations. More likely than not, the L5-S1 disc will eventually tear. This might set up lower back pain which is chronic but some patients will get disc tears without pain.

    You can also have the pars fractures repaired if everything above is true. The long term outlook of this repair looks good but the longevity is still under investigation.

    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.
    cotymorris
    Member
    Post count: 14

    I have no medical insurance. So I’m not sure its pristine. The radiologist said that it was just the fractures, but I would think they could have overlooked something… I just want to return to sports and working out. Do you think bracing would get me back?

    Thanks so much.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8378

    Bracing will allow the pannus to heal somewhat (see website under isthmic spondylolisthesis) but the brace is only as good as your reduction of certain activities. Extension (bending backwards) will cause the healing tissue to tear apart. The brace is designed to remind you not to bend backwards but it is not perfect. You can overcome the brace’s prevention ability if you do not pay attention.

    Without insurance, I would assume the cost of surgical repair might be too expensive for you. There are many individuals with this disorder that function without too much pain. You just have to be careful. Football does require torsion, loading and extension (unfortunately just the maneuvers that can aggregate this condition). Playing that game will put you at more risk than if you can avoid it. Your decision is if playing football is worth the risk of aggregation of the disorder.

    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.
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