Spondylolysis/Spondylolisthesis? (lower back pain)
Been having a run of bad back pain for the last 4-6 weeks after trying to put a new movement into a weightlifting workout. Went to the general practitioner since I was a couple years past due for a checkup anyway. While there he did some x-rays of my back to see what was up. X-ray clearly showed a small piece broken off the anterior side of L3. I brainstormed the past few years of dumb shit done and drilled down to a time that I stacked up on a pillow line in BC and had to spend the rest of the hut trip laying on the floor. He figured that the piece was stable as it is held in place by ligaments, but figured the trauma required to break it possibly damaged the disc space, and it was irritated from the workout. Fast forward two weeks and it was feeling great again. Good enough that I decided to tackle some yard work that required a ton of shovel time.
Wake the next day after the yard work and the back feels fine, until I lift something that weighed 5 pounds and twisted with it. Bam done. Been pretty much laid up with pain since then (9 days yesterday). Went to see a specialist yesterday and tell him the whole story, he pulls up the x-rays. He sees the "inconsequential" break that the other doc had seen, but said the GP missed the fact that I have Spondylolysis.
The break (Spondylolysis) allows the vertebrae and disk to shift forward and pressure the nerve, hence the pain. He said the definitive treatment is fusing the back, but obviously doesn't want to start there. I started on predisone to try and relieve the swelling and allow the disk to move back into it's space. Once that happens, start PT to learn proper movements and strengthening exercises to protect it from movement in the future.
Radiologists report: Bones: L4 vertebral body limbus deformity. No acute fracture or dislocation. Remaining lumbar vertebral bodies maintain normal height. L5 pars interarticular is defects. 6 mm anterolisthesis of L5 relative S1, which appears stable on flexion and extension imaging.. Intervertebral disc spaces: Mild loss of L3-L4 intervertebral disc space Soft Tissues: Overlying soft tissues unremarkable IMPRESSION: Bilateral L5 pars interarticular is defects, with mild grade 1 spinal listhesis of L5 relative S1. Spondylolisthesis appears stable on flexion and extension imaging. Limbus deformity at the anterior superior corner of the L4 vertebral body, chronic in nature.
So, long story for my question: Based on that report, did I interpret what I was told correctly? Anyone live with this? What is active life like? Have you had "episodes" of pain from doing too much work /lifting wrong? I mean, apparently, unless I broke it from shoveling (unlikely?), then I've been living an active life with it? I mean MTB has caused me lower back pain since that ski wreck, but I'm able to tolerate it with enough stretching and working of the opposing muscles.
Spondylolysis/Spondylolisthesis? (lower back pain)
6 mm is a decent slip, we fixed one yesterday with less than that but it was in a patient with prior L2-5 fusion and we extended it to S1. Work on your core strength and flexibility, avoid spinal surgery for as long as you can.
Oh, posture is everything, don’t let your pelvis roll forward, engage your abs and tuck your butt. You’ll notice a marked difference.
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