[jtspine47]

#33655

Hello Dr. Corenman,

If someone has a low grade spondylolisthesis (1 L5/S1), is it still possible to repair the defect and decompress the foraminal spaces (or even reallign the vert’s with the screw technique) as opposed to fusion technique?

While the disc isn’t perfect white in the MRI like all the 4 above it, it’s height is still significant and I feel like maybe fusion could be avoided if the spondy progression was halted by a repair of the fracture and maybe opening up those nerve spaces… Thoughts?

[Donald Corenman, MD, DC]

#33659

There are many factors that affect the suitability of pars repair. The older the patient (20s-30s) the more difficult it is to get a repair to heal. The type of pars fracture (atrophic vs hypertrophic) makes a big difference. Also, the amount of separation of the ends of the fracture lends a considerable factor in poor healing. If there is a slip, this means the disc is at least deformed by stretch if not partially torn which makes repair even more difficult to gain a satisfactory result.

If you have a pars repair but don’t get a good result, you can still revise the repair to a fusion, but you sacrifice at least 6 months to one year of your time and then have to go through a second operation.

If you have a higher age, a slip and a degenerative disc, you would be happier with a fusion of that level.

Dr. Corenman

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