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Spondylolysis L5-S1
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Spondylolysis L5-S1

I have just been diagnosed with the following. I am hoping to get some answers or direction on what i should do next.

Xray Findings:
5 views of the lumbar spine show spondylolysis at L5. there is no spondylolisthesis. the disk heights are well maintained.

MRI Findings:
On the sagittal images, the conus ends at the appropriate level. There is no evidence for vertebral body fractures. There is no evidence for significant disk desiccation.

On the Axial images at the L1-2, L2-3, and L3-4, there is no evidence for central canal stenosis, neuroforaminal stenosis, or herniated disk.

On the axial images at L4-5, there is a small central protruding disk with a minimal annular tear suspected within it. there is no evidence for significant central canal stenosis, neuroforaminal stenosis, or herniated disk.

On the axial images at L5-S1, there is no evidence for central canl stenosis, neuroforaminal stenosis, or herniated disk. there os suggestion for a pars defect at the L5-S1 level, which would probably be best evaluated with plain film. DJD at pars defect extend into the central canal and does effect the dorsolateral aspect of the thecal sac. Edema seen at pars defect. No significant spondylolisthesis is identified.

Impression: The most significant finding is at the L5S1 level as described above. There may be a pars defect, but no evidence for herniated disks. Ct or plain film correlation to evaluate the possible pars defect would be helpful if clinically warranted.

CT Findings:
Notes bilateral pars interarticularis defects at the L5 level which have not changed. No acute fractures of the vertebral nodes are demonstrated. there is minimal narrowing of the L3-L4 and L4-L5 intervertebral disk space. there is mild physiologic narrowing of L5-S1 intervertebral disk space. there is no intervertebral disk protrusion at any of the scan levels. the neural foramina are not abnormally narrowed. there is slight hypertrophic degenerative arthritis of the facet joints at the L4-L5 and L5-S1 levels. there is a Schmorl's node inferiorly at the L1 level. The visualized paravertebral soft tissues appear normal.

Conclusion: Stable appearance of the lumbar spine CT scan since 9/29/07 again showing bilateral pars interarticularis defects at the L5 level and mild hypertrophic degenerative arthritis of the facet joints a L4-L5 and L5-S1. No intervertebral disk protrusion is demonstrated on this study but as noted on the previous study if there is clinical suspicion of nerve root impingement, an MRI study is more sensitive.

Any suggestions would be great. Im not even sure what some of this stuff means. Im in between doctors and am waiting to get a pain management specialist approved by the State (This is an on-the-job injury)
Thank you in advance!!!!
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Hi Dodgegirl,
Welcome to to MedHelp's Pain Management Forum. Please understand that I am not an expert and their are no physicians on this site.  

Bilateral pars interarticularis defects is also called spondylolysis, which consists of an interruption of the vertebral arch at the bony bridge that holds together the superior and inferior articular processes. Heredity also is believed to be a factor.

It is my understanding that this condition usually responds well to conservative treatment. A PMP will probably offer you treatment as well as some pain control until the condition is more stable.

Others will post with their suggestions. Sundays can be a bit slower than weekdays. Best of luck to you and please let us know how you are doing.

Take Care,
Tuck
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