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L5/S1 fracture

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Let me start off by saying I had a pretty good fall about 7 years ago from a hunting accident. The tree stand I was in actually broke and I went with it to the ground about 20 feet before I landed on my stomach. Granted this was the only time I had forgotten my safety harness it cost me in the end. I couldn't get out of bed for 2 days afterward, but never had an x-ray or anything done, which I now know I should have. Now about 4 months ago I started having really bad back pain, but just dealt with it, until now. About 2 weeks ago I went to see my regular doctor and she recommended I get an x-ray. I got the x-ray done and she said there were "abnormalities" near L5/S1. I requested to see a neuro doc at the recommendation of my mom who is a nurse. So a couple days ago I go see the neuro doc and he says I have a fracture of the L5/S1. He also gives me 3 options. I can do exercises to strengthen the muscles in my back to help alleviate some of the pain, wear a brace, or have surgery. I'm 24 years old and not exactly sure how I want to approach this, so hopefully someone that has had this or a similar experience can offer up some advice to me. The pain does not go down my buttocks or down my legs, but the doctor said over time that could happen if it slips even more. I sometimes get some spasms at random times, doesn't matter if I'm standing, sitting or laying down. I can really feel the pain when I bend over to pick something up or bend over and lift something then it's a really sharp pain in the L5/S1 area. I really don't want to have to wear a brace if there is no way that it will heal itself and I'm not too keen on the surgery after all the horror stories I hear from back surgeries, but if it will fix the problem and not cover it up then I am considering that route, but wanted to see what others thought. I appreciate any and all opinions/thoughts. Thanks.
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replied October 22nd, 2008
Extremely eHealthy
I would seek out a second opinion with a sports medicine orthopedic surgeon that specializes in spines only.

The neurosurgeon gave you options but he/she express an opinion on which option was the best for you to follow?

An unstable spine will continue to create further problems in your spine. The doctor said you could develop further problems if the vertebrae slips even more.

I understand your concerns about surgery at your age, which is why I suggested you see a sports medicine orthopedic surgeon that specializes in spines.

They will be more familiar with dealing with someone your age, more up to date on various techniques to minimize the need for surgery and if surgery is suggested to you, then they will do the most minimum possible in surgery.

You should always have at least one other opinion before considering the surgical option.

Since you are unsure how to proceed, it would be even more important to seek out other opinions, especially if your present neurosurgeon did not express his/her opinion on what was best for you in this situation.

One other thing, if you fell about 7 years ago, I doubt that your fracture was caused by this incident. You may have caused some injury that indirectly caused the vertebrae to fracture, but, if the fracture occurred 7 years ago, it would have healed on it's own by now.
It sounds like this fracture is something new.

Please seek out the opinion of another spine surgeon as soon as possible.

Fran
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replied February 6th, 2010
i am gong through the exact symptoms and i had a rally injury 5 years ago i began feeling the pain 8 month ago while doing wake boarding the doctors told me that what they told you exactly and i am doing the surgery in germany on the 16 th of feb i u did the operation u might have advice to me please write me i hope your feeliing better by now.
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replied February 9th, 2010
i am also 24 years old and also had 2 fractures in my l5 but mine were actually pars fractures im not sure if that would be close to the same or not but i went to physical therapy before i had surgery and got the bone fusion and screws done and the pt actually made it worse for me because my mayo doc said that when i was going to pt it was actually stressing the cracks more and more every time i went
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replied February 12th, 2010
thank u for u reply mine is a pars fracture also and please tell me what kind of surgery u did and am sorry i dont know whats the pt ,did u have any spazms in ur upper back after u injury and did the physical surgery help by anymean
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replied February 14th, 2010
get other opinions-i am a nurse disableb by a l5 s1 fusion
neuro docs tend to be the preferred ones. get all the tests you can find out about and learn about your anatomy and what is wrong. surgery cannot be undone NO GUANANTEES.
if nerves are pinched then they can be permanently damaged but sometimes waiting or not having surgery iss the conservative choice. need to figure how much pain and pain med you take now versus how much you will take after the surgery- after it heals
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replied April 28th, 2010
Pars Fractures
I was diagnoised with Pars Fractures at L5 in August 2009, from a scan, after having the sensation of something moving in my back during a gym class in the March of the same year.
I have been having physio now for 8 mths in total, and although I feel I little stronger, I cannot stand or walk for more than 10 mins.
I have a scan this week to see the progress and discuss options for injections or sugery. Any advise or experiences would be welcome
JWJ
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replied June 15th, 2010
L5 fractured
i am 11 weeks into an L5 compresssion and burst fracture. I am pessimistic about the prognosis without surgery. What did u decide to do in the end illicit? and what was the result please. I am trying to find information on outcomes with or withour surgery, can anyone give advice? currently wearing a tlso brace with thigh extension for another 6 weeks but unable to bear any weight while standing without support
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replied March 4th, 2011
l5 / s1 compression fractures
I had a compression fracture of L% and underwent kyphoplasty for it. It releived 90% of the pain. Now I have an S1 compression. There is no FDA approved treatment for this. I am inn alost as much pain as from the original L5.
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replied March 4th, 2011
l5 / s1 compression fractures
I had a compression fracture of L% and underwent kyphoplasty for it. It releived 90% of the pain. Now I have an S1 compression. There is no FDA approved treatment for this. I am inn alost as much pain as from the original L5.
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replied March 15th, 2011
L5 PAR fracture and more
I'm also 24, I ran track for 18 years and Feb 13th '09 was in an MVA, bus to bus. I suffered multiple injuries and on Friday received my MRI results back.. L5 PAR fracture. Since the accident in '09 I have had numbess from my left gluteal fold to my last floating rib (T 11-12) when I sit for a prolonged period of time and of course pain 24/7. Sleeping sucks, standing sucks, sitting sucks. I also have DDD in L 3-4, T 11-12 and protruding disks L 3-4 and T 11-12. They referred me to PT, haven't scheduled anything yet, too many other doctor apts to take care of (I tore my PCL 3 weeks ago). I'm a mess Smile
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replied March 19th, 2011
Re: L5/S1 fracture
I would never, ever have surgery after talking to just one doc no matter who he/she was. Always get atleast three opinions before going under the knife with bath issues.

Sometimes we have no choice and have to go the surgery route.......or atleast thats what I was told by the doc. I learned the hard way by not getting a second/third opinion just because my doc had an important job title at Vanderbilt (I was told he was the best at what he does) and let him put pins/screws/fushion/disc replacement at S1/L5 just because he said "you have no choice, unless you want to stay in pain for life and end up in a wheel chair".

Before surgery I would rate my pain (1 to 10) around 4ish on most days and maybe 7ish on the worst days. Now my pain level stays around 7ish on good days and a freaking 10 on the bad days.

I did'nt have to take pain meds before surgery........lol......now, I feel like a junkie waiting on the next fix.





illicit wrote:
Let me start off by saying I had a pretty good fall about 7 years ago from a hunting accident. The tree stand I was in actually broke and I went with it to the ground about 20 feet before I landed on my stomach. Granted this was the only time I had forgotten my safety harness it cost me in the end. I couldn't get out of bed for 2 days afterward, but never had an x-ray or anything done, which I now know I should have. Now about 4 months ago I started having really bad back pain, but just dealt with it, until now. About 2 weeks ago I went to see my regular doctor and she recommended I get an x-ray. I got the x-ray done and she said there were "abnormalities" near L5/S1. I requested to see a neuro doc at the recommendation of my mom who is a nurse. So a couple days ago I go see the neuro doc and he says I have a fracture of the L5/S1. He also gives me 3 options. I can do exercises to strengthen the muscles in my back to help alleviate some of the pain, wear a brace, or have surgery. I'm 24 years old and not exactly sure how I want to approach this, so hopefully someone that has had this or a similar experience can offer up some advice to me. The pain does not go down my buttocks or down my legs, but the doctor said over time that could happen if it slips even more. I sometimes get some spasms at random times, doesn't matter if I'm standing, sitting or laying down. I can really feel the pain when I bend over to pick something up or bend over and lift something then it's a really sharp pain in the L5/S1 area. I really don't want to have to wear a brace if there is no way that it will heal itself and I'm not too keen on the surgery after all the horror stories I hear from back surgeries, but if it will fix the problem and not cover it up then I am considering that route, but wanted to see what others thought. I appreciate any and all opinions/thoughts. Thanks.
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replied September 30th, 2011
L5 and S1
I am 27, 2 years ago I was told to get surgery. I decided to wait because I was scared. I do have pain that goes down the legs and tingling sensation. I think I will keep waiting until I can not stand the pain at all. I have met few people that had surgery and they did not get much better. In fact, you may need more than one surgery down the road. Go to more than 1 doctor if possible. Go to Physical therapy and to a chiropractic that concentrate in neurological problems. That really helped me. Good Luck
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replied October 26th, 2011
Back Pain - Acupuncture
I have found that the best treatment for pain in the back is acupuncture. Find a qualified (highly trained) medical doctor who uses acupuncture. My physician, Dr. Hsu (Oklahoma City), was trained in China in eastern medicine and here in the U.S. for western medicine. After 3-5 treatments, I'm good to go (unless I do something stupid like picking up something heavy)......I'm learning to live more mindfully.....watching myself to see that I am careful. It is amazing........
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replied December 23rd, 2011
L5-S1 spondylolisthesis with L5 pars fracture
I am a 43-year old nurse (now stay-at-home mom to my 6 & 2 yr old boys). I have been athletic all my life, but was diagnosed with L5-S1 herniation at 27. I had tried chiropractic treatment, yoga, PT seeing orthos and neuros in the past.

In 1999, I was diagnosed with a pars defect. Since then, I continued to play tennis, squash and various other sports and had 2 children. My youngest son just turned 2 this month, but I had been unable to do anything life before he was born (I was on the tennis court at 5 months pregnant).

I finally saw a neurosurgeon who said that my pars defect was now a fracture. People are either born with it or it is caused by trauma. I did have a car accident in 2002, so it could have started then or who knows. My ONLY option to fix this was surgery. I got the opinion of 2 other neuros. A fracture at the L5 level like mine could not be fixed without surgery. I never had any radiating pain down my legs so he said while I can wait a year, it will continue to get worse until I do have leg involvement.

My Dx: L5-S1 spondylolisthesis with L5 pars fracture. Surgery: L5-S1 lumbar laminectomy transforaminal lumbar interbody fusion with instrumentation (4 titanium screws). I am 1 week 1 day post op and am only taking a muscle relaxer an occasional Norco. I drove for a short distance today by myself having had help all week. I still cannot lift anything for 5 weeks, but I consider my surgery a success so far. The only thing I feel is tired after doing too much too fast. I know I should relax. I was scared to death of this surgical option, but I was also glad it was the only one I had as this was the same surgery offered to me 16 years ago. I am amazed at my recovery so far. I hope this gives hope to some of you out there. I lived with off and on pain for years. I can already tell a vast difference and it's all good.

Merry Christmas!
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replied December 31st, 2013
L5 burst fracture/no surgery
Hey guys - so I had a L5 burst fracture from a car accident in August, and my ortho surgeon decided to not do surgery. I was at first unable to even sit up, but with the right rehab therapist (inpatient) I was able to sit up, and eventually walk with the walker. I was sent home from rehab after one month, and continued home physical therapy 3X a week for 2 months, and then 2X a week for a little under one month. Early on, my symptoms included intense lower back, hip, leg, and foot pain, which evolved into numbness and random muscle spasms. The numbness is particularly strong in the outer calf, top of foot, and big toes. In the last month, things turned for the better. I am now able to walk with a crutch and AFO for a bit, can now drive a car again, and I have returned to work part time. I still take Baclofen, Gabapentin, and Ibuprofen. I still have the numbness in feet and soreness in lower back, not so bad in AM, progressively gets worse into evening and night. I plan to continue regular therapy (2X a week) in the new year, as well as start up on the recumbent bike. So I think every case is different, but some L5 injuries may not necessarily need surgery.
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