Spondylolisthesis--Grade III--Treatment?

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got2ryd

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I was diagnosed with spondy about 10 years ago, at which time it was being treated by a chiropractor. As far as I remeraber, it was a grade I at that time.

I was involved in a serious motorcycle collision Nov 2010. I didn't feel like my back hurt at the time of the collision, however I was more worried about my throat (later diagnosed as a fractured larynx). Anyway, while I was intubated, they made me cough and I felt a rip in my back. It has hurt since. Minor leg pain symptoms, but I do occasionally get very bad spasms across my lower back.

I went to a back doctor mainly to get a physical therapy script in order to do some core exercises (while I rehabbed my fractured wrist too). He ordered
x-rays and an MRI. He called, slightly panicked, 2 days later with the report and told me to stop doing any type of "high impact" activities (I ride horses long distances competitively) and to go see an orthopedic surgeon.

The report was a grade III spondy with acute pars fractures which the back doctor diagnosed as being from the collision ( I t-boned a car while on my motorcycle at 30 mph). I have yet to see the surgeon (this Tues) but of course have been reading up on the net. My gut says try PT for a while and see how it goes, but then again, with a 75% slip (2.4cm), I don't want to wait for it to get worse. And I need to ride horses ASAP. Anyone had surgery to correct this? It's at L5/S1.
 
It sounRAB like you lead an adventurous life, and that some of the rough impact has caught up with you. I am sorry you find yourself in this situation and hope you are recovering from the crash.

Unless there is new technology that I am unaware of, the only thing that will keep the spondylolisthesis from progressing is a fusion. The problem caused by spondy is that the spine is unstable at the segment, and the spinal roots as they exit the spine end up getting pinched off. This results in nerve compression which can permanently damage the nerve and intense sciatic pain running down the back of the leg, sometimes into the foot.

Any activity where the spine is in extension will be very hard on the spondylolisthesis...from swimming any stroke where you're on your stomach in the water, back benRAB, sleeping on stomach, and any activity where there is any kind of impact would also be potentially dangerous with this instability.

At the least I would imagine you would need a one level fusion at L5-S1. Fusion is major surgery and recovery is not fully complete for at least a year (to the point where the new bone is hard and strong), although bone growth can start as early as three weeks. Most people are off work anywhere from about two months to six months, sometimes a bit longer.

PT will do little for the instability -- depending on treatment, it could even make the situation worse. This is not a condition that fixes itself. Either one lives with the pain and hopes for the best, or one has surgery.
 
Did you see the doctor today? Did he/she have a plan of treatment for you? Please keep us posted on your progress!!
 
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