Spondylolysis/Pars Defect

Spondylolysis/Pars Fracture: Surgical Treatment Part 4


Frequently-Asked Questions:

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

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?
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.


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