Tagged: Direct pars repair
Donald Corenman, MD, DCModeratorNovember 5, 2017 at 5:45 pmPost count: 6401
“Do u think that its possible that the hardware could be rubbing and irritating the muscle and tissues and causing my discomfort”? Possible but less likely The deep unilateral pain might be from delay healing, hardware (as you note above) or even some nerve irritation.
Dr. CorenmanPLEASE 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.If this forum has helped you, please let Dr. Corenman know!JeremyDParticipantNovember 8, 2017 at 3:06 pmPost count: 11
If it is “delayed healing”, How long will the pars continue to try to fuse before it gives up and becomes sclerotic? Also, If this repair fails would the next step be fusion? Even with a healthy disc ? Or would another attempt at pars repair be logical? I understand Fusion success rates are very high with the big cages and implants and strong hardware. I do understand that the 6 month ct Scan is very important to evaluate the pars anatomy and detail. I just cant imagine having to sacrifice a healthy disc and undergo a fusion at age 31. Dr. Corenman what is your opinion on this?
Thank you -JeremyDonald Corenman, MD, DCModeratorNovember 11, 2017 at 11:03 amPost count: 6401
It can take as long as a year to have a successful pars repair.
The circumstances depend upon the findings on CT of the repair. Is the fixation (instrumentation) still good or is there haloing (motion around the screws/hooks)? Does the bone graft appear to “try” to heal or is it atrophic (thin)? I have repaired about 30 pars but have never tried a revision as even with the non-healed ones (10% or 3 failures), I have only converted one to a fusion as the other two have adapted to the non-union and needed no further attention.
If your disc still is in good condition and the hook,screw construct can be removed safely without jeopardizing the potential to repair and fix the pars defect, you might be a candidate for a revision.
Dr. CorenmanPLEASE 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.If this forum has helped you, please let Dr. Corenman know!JeremyDParticipantNovember 13, 2017 at 1:36 pmPost count: 11
I understand now, thank you for the clarification. I feel a lot better about all of it now. I do feel stable now compared to before surgery. I think most of my discomfort and confusion has been part of the healing process as the muscles still “fatigue” and flare up. I have also read that even the rare occasions of non-union people are still able to carry on with their “normal” lives and adjust as you stated. My surgeon did use BMP’s with my repair and believes that my CT scan 6 months post op will reveal good news. He feels great about it. So we will see in January, Again i thank you for your detailed explanations, your time and knowledge as well. I have never heard of a Dr. creating a forum for patients to ask questions and concerns in their desperate times. It truly is appreciated!! -Jeremy
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