First of all, who is indicated for surgical treatment of lumbar spondylolysis (also called pars defect or pars fracture)? Nonsurgical treatments, such as physical therapy, bracing, activity limitation, injections are the primary interventions. These can be done for as long (months to years) as the patient is functioning at an acceptable level and has and […]
Category: Spondylolysis/Pars Defect
Spondylolysis/Pars Fracture: Surgical Treatment Part 6
The last blog post demonstrated my preferred method to fix spondylolysis/pars fractures, when nonsurgical methods fail to adequately relieve low back pain. There have been other method to stabilize the surgery as demonstrated below: The below case demonstrates why I prefer pedicle screw fixation-rod-laminar hook fixation: At this point he was 1 year out from […]
Spondylolysis/Pars Fracture: Surgical Treatment Part 5
If the nonsurgical treatment discussed over the last 2 posts fails to adequately relieve the low back pain due to spondylolysis/pars fractures, then surgery might be indicated. It is important to note that not all patients have the same pain intensity, frequency or interference with activities. The radiographs of the spondylolysis/pars fracture may look identical […]
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 surgery. If I have been […]
Spondylolysis/Pars Fracture: Nonsurgical Treatment Part 3
So far we have described the anatomy of the vertebra, the location of a pars fracture/spondylolysis, how it develops, and how we can diagnose it. Now we will discuss how to treat a pars fracture/spondylolysis. As mentioned in an earlier post the main symptom is low back pain, which typically increases with sporting/athletic activities, and […]
Spondylolysis or Pars Fracture
To summarize the previous post, the pars interarticularis likely never developed normally for individuals who get a spondylolysis or pars fracture. With continued stress on this area during normal and athletic activities the abnormally-developed pars cannot handle the repetitive stresses applied and a crack develops. If the pars is bone, why doesn’t it just heal […]
Spondylolysis or Pars Fracture
Before we talk about what is Spondylolysis or Pars Fracture, we need to understand what is normal. So, what is normal vertebral anatomy? As you below in the two drawings the vertebra of 3 parts: the vertebral body (which is in the front), the posterior elements (in the back; red circles), and the pedicles […]
What is Spondylolysis or a Pars Fracture?
If you break the word spondylolysis down to its Latin roots and then translate to English you get spondylo- which means “vertebra” and lysis which means “crack or break”. So spondylolysis is when there is a crack in the posterior, or back part, of the bony arch of a vertebra at the pars region (see […]