Non union of Pars Interarticularis

[Haichi818]

I have already had 10 various injections for pain relief and am due to have 6 more soon 4 x facet joints L4/5 L5/S1 and Pars L5 and Coccyx + mua.

I had a bone scan in summer 2008 which showed non union of the pars defect and no activity within the bone, so basically it wont heal, what is the prognonsis long term for this?  Just wondering if anyone can help me?  In a lot of pain, for which I have butrans transdermal patch 20microgram/hour which sometimes is just not enough.  I find it hard to sleep and have pins and needles numbness and "dead leg" at night in my left leg.

Many thanks

[Haichi818]

Thank you for the advice!  

I am waiting for an appointment at the moment, so will chase it up.

Thank you very much

[Dr Vinod]

Physiotherapy is the best thing, you have to work hard and select a good perfectionist as this is very important.
I agree with the surgeon, he is going conservative and wants to try all options before trying surgery.
Steroids should help you after you start some Physiotherapy.
Take care!

[Haichi818]

Hi thanks for your post.

I have had physiotherapy but it was quite painful and am on a waiting list for physiotheraphy with a lady who is trained in chronic pain management but I dont know how it will help because of the non union?

I have had 10 injections (steroids) last year and at the end of the month I am having another 6 and praying that they work this time.

I have heard such horror stories about surgery, but my surgeon wont operate until the discs obliterate and because he says I am too young.

Just getting a bit desparate now as the pain is getting quite hard to manage.

Thanks

[abhijeet v ghosh]

Hi buddy,
any person with pars defect, should be given treatment as follows
1) Begin with physiotherapy. A 4-6 months of good physiotherapy, should help the patient. If pain is persisting, then
2) Give steriods course. It can be done orally or interatricular route or epidural route.
If steriods fail,
3) Surgery is the option.
Please discuss it with your surgeon.
Feel free to ask me more,
regards