Sacral stress fracture healing time

Tagged: Sacral stress fracture

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Jhageman08
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July 5, 2016 at 10:40 pm

Post count: 2

#22557

Dr. Corenman,
I found in one of your other post you had previously only encountered one sacral stress fracture. I’m curious of the it one of that case? Here’s my history. Three months ago I lifted a very heavy mower with a friend in order to move it onto a trailer, about 600 pounds. Three days later I had tingling in my quad muscle on the right side accompanied by lower back pain mostly on right side. Your thinking the same thing I was at the time herniated lumbar disc. Wrong Infact my coworker scanned my entire spine and I had not one single bulge or degenerating disc. I assumed it must be something muscular then so I went to the chiropractor and she said I had some muscle spasm which I agree with and that’s why I was having the tingling. After about a month I started working out again and playing sports. At this point I’m still not one hundred percent but it feels like it’s improving. I was also doing stretches everyday as wel but I noticed when I did lumbar rotation exercises I would feel a pop in my right so joint when I twisted my legs to the left. Two months after initial injury I squated heavy weight and had intense lower back pain with spasm in lower back groin and buttocks. Fortunately I have access to advanced imaging which I’m sure you have already figured out so we did an mri on my sacrum since that was he area of pain and I had inflammation on t2 fs images. A rad looked at it said no way it was a fracture. Went to an ortho he said no way it was a fracture there would be a case study about me if it were. Ortho gave me medrol dose pack and told me I would be fine do what I want. Fortunately I didn’t listen I took the medrol it didn’t do anything so we scanned it again and it cleared up some of the inflammation in the bone and the fracture line was more visible now. Did a ct scan of same area and you can appreciate it on thin images. Rad confirmed the ct and second mri to indeed have a fracture. Its small but very painful. In the region of the ala there also may be some torn ligament in the same area that I found on my first mri after going back and looking at it. I’m certain I sprained the anterior sacroiliac ligament on my right side and possibly torn some of it as well. Chiropractor even said she felt a little motion in it the very first time I went to her. My question for you is what is my prognosis? I know there’s not much that can be done that’s why I didn’t go back to the ortho the rad told me to give it rest for a couple months and it wouldn’t be fully healed for 3 to 6 months. I bought an si belt and it has helped tremendously with the pain from muscle spasms probably because it’s taking stress of the joint and doing its job. Will I ever be fully healed? Would you recommend doing some exercises to strengthen the muscles in the area and if so when? Thank you so much for your time!

Jhageman08
Participant

July 5, 2016 at 10:56 pm

Post count: 2

#22558

Oh yea there was also some free fluid in my pelvis on the first Mir that was nearly gone on the second mri(after taking the steroids).
By the way the radiologist is the one who called it a stress fracture but it almost seems and looks more of an avulsion type fracture to me.

Donald Corenman, MD, DC
Moderator

July 9, 2016 at 10:06 am

Post count: 8660

#22570

Stress fractures of the sacrum are rare due to the design of this bone and the strong sacroiliac joint ligaments. If you have a stress fracture, don’t have a history of significant fall or injury and you are young, the first thought would be a bone disorder such as osteoporosis. A bone density scan might be in order. Avulsion fractures typically occur in bone with lots of movement and the sacrum is the very opposite of that. There is a disorder called Bertolotti’s syndrome (see https://neckandback.com/conditions/bertolottis-syndrome-colorado-spine-surgeon/) that might fit with your disorder.

Sacral stress fractures take three months to heal. The MRI will have changes long after the fracture heals so the CT scan is the best source for healing information.

Dr. Corenman

PLEASE 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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Donald Corenman, MD, DC

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81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

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