Blog Post: Spondylolysis/Pars Fracture 7-24-2021
Part 4: Surgical Treatment
When should surgery be performed for spondylolysis/pars fractures? There is no one answer for everyone, as every situation is unique. Since nonsurgical management (mentioned in last blog post) may effective in minimizing or eliminating pain, it is necessary to see if this method is successful before undergoing surgery.
If I have been doing nonsurgical management, and still have pain, how long should I continue nonsurgical management? We try a minimum of 3 months of nonsurgical management (physiotherapy, pain medications, activity limitation and possible bracing).
If I have had pain for years, should I do nonsurgical management? In situations with longstanding pain, a surgical repair may be the best option. There is a low chance nonsurgical management will be effective.
If I have done nonsurgical management and my pain is better, should I have surgery? No. Surgery should only be done if there is pain which is not acceptable. If surgery is not necessary and the spondylolysis occurs in a younger patient, <12 years of age it is important to get intermittent radiographs of the low back to watch for any potential slippage (spondylolisthesis) of the vertebra forward. We will discuss spondylolisthesis in future posts.
How will I know when I should have surgery? When pain is interfering with activities that you enjoy, nonsurgical management has failed to adequately relieve the low back pain, and you are frustrated with the persistence of symptoms despite appropriate nonsurgical treatment.
What are the surgical options? The surgical repair is aimed to simply getting the crack in the vertebra to heal, without a fusion between vertebra, so no back motion will be lost.
In the next post we will discuss surgery for spondylolysis/pars fractures.