DanielMemberMay 14, 2013 at 11:01 pmPost count: 14
I have a bilateral L5 pars fracture that I have been dealing with for a little over 3 years, I an now 21. I have been looking into pars direct repair and am wondering if you have any advice. I have been to a back specialist at Mayo Rochester, MN and she said that i have no instability and no slippage. Also my discs are in good shape as well. I’ve done some research on the pars repair surgery seems to me that it is succesful especially for me without other problems in my back and that im so young, but the doctor at mayo didnt want me to do that and im not sure why exactly. My pain isn’t terrible but I definitly want to get this taken care of. Any help you could provide would be great
ThanksDonald Corenman, MD, DCModeratorMay 15, 2013 at 8:37 pmPost count: 8465
I have been repairing pars fractures for about 15 years now and can lend some advice. The disc has to be fully intact by MRI, there can be no slip on flexion X-ray films and the “gap” between the fragments has to be less than 3mm based upon CT scan. A hypertrophic pars fracture heals much faster than a hypoplastic fracture (this is also based upon CT scan). Direct repair (pars screws) seem to have better results than figure of eight wiring and pedicle screws/lamina hooks.
Dr. CorenmanDanielMemberMay 17, 2013 at 5:00 amPost count: 14
Ok i will look into all of those. After the bone graphs/bmps heal are you basically able to do anything you want? Does the repair last a long time and remain strong?
ThanksDonald Corenman, MD, DCModeratorMay 17, 2013 at 11:00 pmPost count: 8465
I have never had a repair that healed fail with the direct technique but that does not mean that it will never fail.
After the repair, there are no limitations.
Dr. CorenmanDanielMemberMay 19, 2013 at 7:30 amPost count: 14
What is the rehab like for this surgery? When would working out and exercising start? I mow lawns and work as a dilivery driver for summer work. How long would I be out of those jobs? Would I wear some kind of a brace while the bone is healing?
ThanksDonald Corenman, MD, DCModeratorMay 19, 2013 at 11:50 pmPost count: 8465
It takes normally six months for the bone to heal (and sometimes longer) before you can load your back. You can do some careful aerobic exercises in the first six weeks and slowly advance but remember that motion is not the friend of bone healing. The bone must heal for the surgery to be a success.
You will wear a brace but this is just a reminder. The brace can be overcome if you don’t mind your Ps and Qs.
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