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Nonunion fracture to L4 superior articular process
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Nonunion fracture to L4 superior articular process

Hello.

I am 25 yrs old, female. I have a very active sporting history, and played squash for several years at competitive level. 18 months ago I started to experience some pain in my right hip. Having an Xray of the hip & pelvis revealed no problems. An MRI was done, followed by a CT Spect Scan. Eventually, in the summer of 2010 I was diagnosed with a non-union fracture to the L4/5 Superior ARticular process. I was advised against surgery due to the risk/return, and set about working dedicatedly to building my core. This has helped mildly with the symptoms but I continue to experience very bad lower back pain, and have been unable to return to competitive sport (which I really would like to do). I have been reading a little about more active forms of spinal treatment: halo vests, spinal surgery, etc. Please could you provide some advice? Moreover, I understand that in some cases the fractured particle may refuse with the original bone - is this true / how likely is this to happen, & if it does, does full healing/recovery take place?

Thank you very much for your assistance.
1083596_tn?1313398276
Dear Friend,
How are you doing now a days?
I would like to address your doubts -

Question = I understand that in some cases the fractured particle may refuse with the original bone - is this true / how likely is this to happen, & if it does, does full healing/recovery take place?
Answer = Fracture may or may not refuse to heal with the original bone. But it hardly matters. If there is a Non-Union of the L4 articular process, then surgery is the best way out. I am really not understanding as why did the medical team advised you, not to go for the surgery.

Surgery would provide an additional support to the non-union region via screws and rods. As far as bone healing is concern, bone grafting will help the cause.
Worst scenario is that, the bone would not join ( ie non-union may persists, but still having an additional support, in the form of rods and screw would surely help).
Hence please re-discuss with a good spine specialist.
Feel free to discuss further or at least please explain me the reason for not doing the surgery, in a better way. Looking forward to discuss more.
Regards.
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