Tagged: Direct Pars vs. Fusion
jtspine47ParticipantFebruary 25, 2021 at 3:34 pmPost count: 2
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, DCModeratorFebruary 27, 2021 at 7:48 amPost count: 7956
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. 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.
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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