Hello I am a 28 year old male with daily back pain due to a recently diagnosed bilateral pars defect with very little vertebrae slippage and little disk degeneration. I Want to live a active life and never have a fusion surgery due to the small amount of positive outcomes I’ve researched after. I am thinking about a direct pars repair and would like to know if I am a candidate for it and does health insurance pay for the second opinion as well as surgery itself? I want to be able to remain active and I work a very physical job which I don’t want to lose due to daily pain. I also would like to continue playing sports.
Any slip generally means there is some incompetence in the disc which is a problem. There are some strikes against you for pars repair. Your age is one. Younger patients tend to heal better and faster although I have repaired some pars fractures in twenty-something patients with not-unreasonable results but the success rate is lower and healing slower. Disc degeneration is another problem. Disc degeneration can lead to progressive disc thinning and incompetence.
The type of each pars fracture is important. Displacement is a negative factor. Non-displaced does better. 3mm displacement is a real issue. Atrophy at the end of the fracture is another negative factor. Of course, if the fracture end is hypertrophic and non-displaced, that would be a positive for repair.
Don’t be too worried if you are not a candidate for repair but are for fusion as many of these patients are very happy with fusion results.
Normally, most insurance companies welcome a second opinion.