Pars Fracture Healing & Surgery
Jo in Washington, USA, asks:
"Could you give me some idea of how long it takes for a stress fracture
in the pars L5 to heal?
My daughter has been out of soccer since 2/23 (3 months) and the Doctor said
it may never heal. Does this happen?
Is there any type of surgery that is commonly successful if it does not heal?"
Colin Natali, Consultant Spinal, Trauma and
General Orthopaedic Surgeon at the back2normal
back and neck clinic, London, replies:
"This is a significant problem and requires accurate
diagnosis and treatment to be instituted.
"Pars fractures can be of several types depending on their
region and can either be old or new. These types and the age of the fracture
can be differentiated using specific tests such as a CT scan and bone scans.
"If the pars fracture is fresh and does not heal within
2 to 6 months consideration of a surgical pars fusion should be at least
discussed. For old pars fractures (older than 6 months), there are typical
features and treatment options are to rest patients from sports for up to
12 months until it hopefully heals, (which it often does not), or to proceed
to a formal fusion.
"The starting point for all cases is an accurate history
and examination. Tests including plain xrays, CT scans, bone scans and MRIs
are useful. Treatment then starts with pain killers, physiotherapy and possibly
injections BEFORE surgical options are discussed. The majority of patients
do not end up having surgery, but it should be remembered that for most patients,
simply reducing activities may reduce the level of pain to an acceptable
level. This must be balanced with the options of surgery - which does not
guarantee a return to high level sporting activities."
More about Colin
Article published: 28th August 2004
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