19 yr old w/ Spondylolisthesis which causes a lot of pain.

[Winel44]

I had an MRI that showed i had bilateral pars interarticularis defects with minimal grade 1 (4 mm) anterolisthesis of L5 on S1.  I later got a bone scan that showed mildly increased osteoblastic activity indentified involving the body of L2 and L4.  They also had micro fractures which are almost healed.  The fracture at L5 shows no activity which meant it wont heal and is permanetly fractured.

My question is that I have constant pain and all i have been given by doctors are low dosage muscle relaxers and anti-inflamitory meds which really didnt do anything.  What would help get rid of my pain?

[Winel44]

The well when the doctors first found out I had Spondylo they gave me a brace to wear for the first month and gave me a low dosage Ibuprofen.  About a month and a half after the finding I had an Epidural Injection into L5 which stopped the pain for about 2 months and the pain has come back.  I have just been taking an anit-inflamatory and muscle relaxer which really didnt help with my pain but the muscle relaxer which i think it was flexeral did help me sleep.  The pain doesnt shoot down my legs at all and is mainly just in my lower pain and it always feels tight and when i bend or twist it hurts.  The doctor i have been seeing doesnt seem to know what he is really talking about and Im going back to the doctor today for some new meds to help with the pain.
Thanks, Ethan

[nurseaudrea]

Oh dear I hope you find some really good doctors. I found out I had spondylolisthesis when I was 21. I am now 34 and 3 spinal surgeries later still suffer with a lot of pain. Spondylolisthesis usually always includes the pars defect, that is why the vertebrae slides forward. When I had my first MRI it also showed grade 1 with 4mm of slippage. It is now at 12mm. I had to have a fusion from L4-L5-S1. My first surgery was done anteriorly (through my abdomen) and fused the vertebrae from the front with cadaver bone, not my own. They did not use any instrumentation. I think that is where they went wrong. All the docs. tell me now that it should have been reinforced with hardware. It all broke down. The second surgery was a hemi-laminectomy at L5 to take out the scar tissue that was strangling the nerve roots causing radiculopathies down both legs.The doctors also think the pars defect that broke apart also helped the scar tissue to build up. It did not seem to help because at the time I had a non-union, it did not fuse. Later, after my 3rd surgery, the leg pains finally went away for the most part. I do still have some risidual nerve pain, but nothing like it was, thank you Lord.

My last surgery was a second attempt at the fusion posteriorlaterally. They put screws in L4 and S1 with a rod and cross-link to connect them. However, they did not put screws in L5 and did not try to reduce (pull it back into alignment) it. I don't know what they were thinking.They again did not harvest any bone from my pelvis, but did have bone that had broken down in my spine, from the first attempt, to use for the fusion; so it was my bone they crushed up and used like glue (very essential). The last attempt did fuse the level at L4-L5, but did NOT fuse from L5-S1. The vertebrae kept slipping forward and for 10 years I have been telling ALL the doctors that I feel movement in that area, especially when I relax my back muscles laying in a prone (on my belly) position, or anytime I rotate like I am looking behind me or bending sideways. They all attributed it to scar tissue or the facets moving. Nonsense.

You know your OWN body and you need to listen to it. It would be a good idea to keep a pain journal. You would write down when you have pain or what makes it worse. What time of day it is better or worse and what type of pain it is. The duration of the pain and the intensity. Where the pain is located and if it radiates to another body part or area. All of this would greatly help your doctor to help treat you.

To answer your question. What were the meds they prescribed you? I know for me anti-inflammatories are a must. By themselves they don't seem to do much, but combined it gives an added benefit of reducing the inflammation in your back. I also took muscle relaxers in the beginning, but it only made me very sleepy and I could not function on them. They may help some people. I did have a very bad reaction to one, but can't remember the name of it, it is a newer one. I had hallucinations, and it stated that it was a RARE side effect. At the time I did not know what caused it but I did some research and found out. Never took the stuff again. Skelaxin is a muscle relaxer that was the least sedating for me. It also did not seem to do anything for me, so again, I stopped taking any muscle relaxers. If you need the sedating effect to help you sleep, I found that flexeril did a great job for putting me to sleep. Just be careful because it also has a hangover effect for some people the next day, kind of like Benadryl.

Have you told your doctors that the meds are not helping your pain? What kind of pain are you having? What is the quality of the pain? Any pain in your legs that seems to travel through your glutes to your legs? If so there might be nerves involved and would need more studies done like an EMG or myelogram. Have they discussed surgery with you. When my spondylo was discovered they told me right away that I had to have surgery. Just be upfront about your pain to the doctor and if they will not give you anything else or different for your pain you may need to find a new doctor who will listen to you. I know you are young and you want to stay away from narcotics as much as you can because it is a terrible cycle in and of itself. The weakest of pain meds I know of is Ultram or Darvocet. Ultram is considered a non-narcotic but it acts on the opiate receptors in the brain like it is, so it also has it's abuse and dependence problems that goes with narcotics. I started on Darvocet (Propoxyphene-generic name) and it worked okay for me until I built a tolerance for it. You only go up from there if you have chronic pain.
I wish the best for you and I hope you have or find a GREAT doctor who will really listen to you. That is half the battle. With the spondylolisthesis make sure you get second and third opinions if they are discussing surgery for you in the future. Good luck and best wishes. If you have any questions please feel free to ask me. I know a great deal about spondylo and have done a lot of research on it for myself. I have been suffering with it when I found out for 13 years.              
                     Audrea