I am currently living in Eastern Europe in a country where the medical care is sub par. A very good friend of mine from this area recently (and mysteriously) broke the last vertebrae in his spine (down near his tailbone). He says the x-rays show that the vertebrae is broken in two places and the "tail" of it is just floating about 5mm away from the rest of his spine.
This man is very active (was training for a marathon), relatively young (30), extremely careful with his health (good diet, no smoking or drinking) and had no major accidents before the pain began. The only advice he has received from his doctors is to get cortisone shots or have the vertebrae fused together, but they have not offered a back brace or any other treatment. My friend is horrified at the thought of spending the rest of his life off of running (as the doctors here tell him) and would very much like to heal more quickly. Is there any advice I can give him or specific treatments that he can request from his doctors?
My other concern is WHY the bone broke. I have asked him to get some bone density screenings and cancer screenings, but can the vertebrae just snap from regular life (or running) in a healthy man?
Sounds like a stress fracture of the pars intra-articularis, or a spodylolysis. This frequently occurs in athletes whose movents involve constant bending and extending. This includes gymnasts, football linemen, shot putters and others. It is unusual among runners, and so i wonder if it is more a result of other training he is doing.
Treatment for most lesions is usually conservative at first. This combines the use of a zero degree plastic brace worn 23 hours a day, and physical therapy to strengthen the core, the lower back, and stretch the tight hamstrings that almost always accompany this injury. Spondylolyses are usually capable of healing when the bone scan is still "hot". If the bone scan is cold, or the pain has not been relieved by conservative management, then lumbar fusion is very effective.
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