Donald CorenmanKeymasterMay 6, 2011 at 10:38 pmPost count: 52
My son, 14 yrs old athlete and “no fear” attitude in 2007 had an anterior
superior endplate of the L3 vertebral body fracture. He sustained this by
jumping off a jet ski. Was told to rest for 2 months (No brace) and it would
heal. Through out the years though, he has complained about back pain
especially when running or jumping. We ice it and rest it for several days and
he gets better.
Recently at a basketball tournament after playing several games he could barely
run. (Prior to this tournament he was running track and doing the long jump….and
did complain about his back hurting then.) I thought that maybe the L3 just
didn’t heal so he had a new MRI but the new MRI showed a stress fracture of the
left L5 pedicle, schmori’s modes along the anteosuperior endplates at L3 and
L4, The L3 focus appeared chronic but mild edema persist around the L4 focus.
Fortunately, no evidence for significant canal or foraminal stenosis or disk
SOOOOOO….our family doctor told him to rest for 2 months (No brace) and he can
resume normal activity when this time is up.
Please give me your opinion. He will be going into High School next year and
wants to play football and basketball. He is an extremely active boy who loves
to wakeboard and water ski too.
I just am praying he will not have to suffer from this injury for the rest of
his life.Donald Corenman, MD, DCModeratorMay 6, 2011 at 10:39 pmPost count: 8459
Your son possibly has multiple problems. One is the superior endplate fracture of the L3 vertebra. According to your report, this occurred when he was ten years old. This fracture could have been a herniation of the disc through the growth endplate which is not uncommon. This creates a “limbus vertebra” when the growth plates close and is related to degenerative disc disease. The L4 involvement indicates that there are two separate disc levels other than the L5 pars fracture that are involved and makes me think of a genetic predisposition.
The other problem is the pars fracture of L5. Is it unilateral or bilateral? If the pars fracture is bilateral, it could be a pain generator. If it is unilateral, it might not be.
The real question is what is causing his pain. If pain is caused by the premature degenerative disc disease, then rest is only used with a severe flair-up. When the symptoms become manageable, then activity is allowed again. If a portion of the symptoms stem from the pars fracture, then the question is should you attempt to allow it to heal. The pars fracture may not be causing all or even most of his pain. In fact, the pars may not be causing any of his pain. You can consult a spine surgeon to see what their opinion is.
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