[Cyndi2018]

#27155

Hi Dr. Corenman,
I’m looking for direction. My son, who is now 19, was injured (bilateral pars fractures L5) in 2012 wrestling/lifting in high school. Note to parents: don’t let you kids so “cleans” or “dead lifts”. The fractures were missed in subsequent MRI’s and xrays so he continued to participate in sports etc. with many “sitting out” periods of a week or so until the tingling down his legs started a year later.

He had bilateral pars repair in December of 2015 with hooks and screws and cadaver slivers. Although he experienced minimal relief during the first few months after surgery, he is now back to the same or worse daily pain two years post surgery.

As a 19 year old, this is really messing with his mental state and we are looking for possible options. He has seen neurologists locally but we are told everything looks just fine and there isn’t any explanation for the pain. We have not done steroid injections as of yet…we were told they inhibit bone growth and the site might still heal more.

He will be undergoing Prolotherapy with Platelets this week. His physician now thinks it might be the muscles never healed. However, I read in one of your posts that this is rarely the issue.

I would appreciate any thoughts you might have on our situation.
Thank you,
Cyndi

[Donald Corenman, MD, DC]

#27158

Pars repairs in the best of hands have about a 90% rate of healing. This means, of course that 10% don’t heal (and maybe even higher). Use of cadaver bone in this type of repair generally does not work. I would assume your son did not heal those two fractures and his pain continues due to the lack of healing. The type of hardware used to try and heal the fractures can occasionally cause pain in the face of a solid repair.

At this point what your son needs is a new fine cut CT scan to determine what is the status of the attempted repair. They do not need to scan his entire lumbar spine as is so often done as the other levels are probably not causing any pain. I would avoid prolotherapy and platelets until you understand his current status. Muscles rarely cause pain by themselves.

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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