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  • nayanore2464
    Member
    Post count: 1

    This is the same patient before 1 month i have taken ur valuable solutions of having the following problem
    1. Lysis of pars interarticularis of L5 – S1 on both sides
    2. Facet joint arthropathy at L5 – S1 facet joints
    3. Minimal anterior wedging of D11 & D12 verebra with Schmorl’s nodes at D10, D11, D12 vertebrae.

    My question is that i am doing the back excerise regularly for the last one & half month
    1) pain is still there what should i do sir?
    2) upto how many years this pain will be there or it is forever with me
    3) I have consulted one doctor he told that there is a tendency to slip thats the reason pain will be there (disc not slipped even 25% by seeing the MRI told that surgery will not viable at this stage)
    4) Iam panic about my back because i have to go to job & have to pass though humpy road about 30 min daily
    5) I am nervous because of the slow pain that there always with me since from last few months.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8427

    You identify an L5-S1 isthmic spondylolisthesis with a grade one slip (0-25% slip of the vertebra on the sacrum). You also have wedging of the T11 and T12 vertebra.

    The upper vertebral wedging is from Scheuermann’s disease when you were younger. The vertebral endplates were soft and you had some fracturing which deformed the vertebra slightly. I assume this is not painful to you and you can ignore this upper problem.

    The pain you experience is most likely from the isthmic spondy at L5-S1. It would be unusual for this spondylolisthesis to slip further down the sacrum at this point as I assume you are at least 30 years of age. Depending upon the length of time of pain and the intensity of pain, there are various options form treatment.

    Physical therapy to strengthen in surrounding core muscles can be very helpful. An epidural steroid injection or a “pars block” at the site of the old fracture can reduce the sensitivity of the nociceptors (pain nerves).

    If you have failed conservative measures or you have weakness of the muscles of the foot (tibialis anterior) from compression of the L5 nerve root, you would be a candidate for fusion surgery of this level. The most typical surgery would be a TLIF (see website).

    Dr. Corenman

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