Probably not a good idea. Pars fractures are defects in the posterior spinal arches that are composed of irregular curved shapes of bone that is relatively thin. Cementing the fracture would not provide enough stability against further fracture and translational sheer forces. Plating would be very difficult due to the curvature of the inferior articular process that are fractured. Rods would be too large for a direct repair. Stress forces on whatever arthrodesis construct employed would probably eventually break down. Most with pars fractures have at least microinstability of the spinal column at that level.

My understanding from my doc, is that there are a number of techniques that have been used successfully in treating pars fracture. Those techniques include iring, interfragmentary screws, pedicle screw-rod constructs, and pedicle screw-rod-hook constructs. See edited to remove link My doc has a good video discussing the various techniques: edited to remove link

But, in the same video the dr. states that direct pars repairs is not for adults, as the spoondylo is never the cause of pain. Do you have any experience with pars fractures? Anybody ever deal with this.

thanks, scott

Pars fractures are indeed not always painful, therefore do not necessarily warrant repair unless there is demonstrated instability of the complex. The pedicle screw/hook situations are indirect repair of the pars by using larger adjacent bony structures for support.

That is exactly, what my doc told me algosdoc. He looked at the MRI and said my discs are in pretty good shape, especially the L5S1, so he believes its the pars defect is causing me the pain. He also did a number of physical tests to confirm. He stated that he wanted me to have the pars defect injected with lidocaine to confirm, and then we could discuss in detail the possibility of repairing the pars. (he also said not to repair the pars unless I have alot of pain. The other test would be a discogram to see if the discs were pain generators, but he thought the pars injectinon would be alot easier on me. He also mentioned that if it is not the pars, he would not consider me for fusion as I do not have any pain in my legs, sciatica, etc. and would rather see me continue with conservative therapy.

So, do you believe I am on the right path with this doc? The challenge for me is that if I am not active, I do not have pain. I would love to be active again, I have 3 small kids and was very athletic, skiing, biking, etc. But, would not consider fusion since I am not in contant pain and there is no apparent nerve impingement. What do you think of surgery to directly repair the pars in my case? thanks.