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What Does "bilateral L5 Pars Defects,grade 2 Spondylolisthesis Of L5 On S1" Mean?

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Posted on Wed, 9 Jul 2014
Question: MRI: 1. bilateral L5 pars defects, grade 2 spondylolisthesis of L5 on S1, and associated severe bilateral neuroforaminal narrowing; 2. Anular tear invlving L4-5 disc dorsally; 3. L5 spinous process possibly fused with posterior elements of S1.
doctor
Answered by Dr. Dr. Praveen Tayal (3 hours later)
Brief Answer:
Details below.

Detailed Answer:
Hello,
Thanks for posting your query.
You are having a disc prolapse at the level of L4-L5. There is anterior slipping of L5 vertebra over S1 vertebra with stenosis of the foramina from which nerves come out causing the nerve compression.
Fusion of L5 with S1 does not cause much symptoms.
The treatment is done according to the severity of symptoms. Medicines are the first line treatment along with physiotherapy. If the patient responds well with medicines then physiotherapy helps in preventing further progression of the problem. Surgery is kept as a last resort to improve the quality of life of the patient.
- Maintain optimum body weight,if you are obese
- Avoid lifting heavy weights as it imparts more strain on your back
- Change your daily activities so that you avoid movements that can cause further pain, especially bending forward and lifting as it will worsen the disc protrusion. if you want to bend forwards, do it with your hips and knees flexed.
- Use a lumbosacral back support to stabilize your spinal muscles
- Intermittent pelvic traction might be helpful to cause a regression of the protruded disc
- After the initial pain has subsided, remedial exercises to strengthen the spine are very important to restore normal spinal movements and muscle strength. The main aim of exercise is to encourage mobility, reduce muscle spasm, prevent further deterioration in the muscles and speed recovery.
- Use analgesics like advil or aleve and muscle relaxants to relieve pain and muscle spasm, as needed. Vitamin B12 supplements & Pregabalin may be helpful in controlling the neuropathic pain.

I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Praveen Tayal (44 minutes later)
Thank you Dr. Tayal. I appreciate your quick response and knowledge very much. This does answer my query and more. It was especially helpful that you listed treatments and measures to take before resorting to surgery, which I would like to avoid. It has been a scary but the more I've learned the less fear I feel. Pain in my lower back region is chronic, occurring each morning accompanied by partial numbness and tingling down my legs. After I walk it off for about an hour I'm fine as long as I don't lift anything heavy the rest of the day. The L5-S1 region feels unstable on a regular basis, with a sensation of compression and a feeling of bone-on-bone at times. The sciatic pain began in 2010 with a mild back injury but has increased in frequency and level of sciatic pain since.
doctor
Answered by Dr. Dr. Praveen Tayal (1 hour later)
Brief Answer:
medicines will help you.

Detailed Answer:
Hello.
Thanks for writing again.
The symptoms that you have described are likely to respond well with medicines and exercise. Please do not worry and stick to your treatment plan. Vitamin B12 supplements & Pregabalin will help in reducing the sciatic pain.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

Answered : 12315 Questions

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What Does "bilateral L5 Pars Defects,grade 2 Spondylolisthesis Of L5 On S1" Mean?

Brief Answer: Details below. Detailed Answer: Hello, Thanks for posting your query. You are having a disc prolapse at the level of L4-L5. There is anterior slipping of L5 vertebra over S1 vertebra with stenosis of the foramina from which nerves come out causing the nerve compression. Fusion of L5 with S1 does not cause much symptoms. The treatment is done according to the severity of symptoms. Medicines are the first line treatment along with physiotherapy. If the patient responds well with medicines then physiotherapy helps in preventing further progression of the problem. Surgery is kept as a last resort to improve the quality of life of the patient. - Maintain optimum body weight,if you are obese - Avoid lifting heavy weights as it imparts more strain on your back - Change your daily activities so that you avoid movements that can cause further pain, especially bending forward and lifting as it will worsen the disc protrusion. if you want to bend forwards, do it with your hips and knees flexed. - Use a lumbosacral back support to stabilize your spinal muscles - Intermittent pelvic traction might be helpful to cause a regression of the protruded disc - After the initial pain has subsided, remedial exercises to strengthen the spine are very important to restore normal spinal movements and muscle strength. The main aim of exercise is to encourage mobility, reduce muscle spasm, prevent further deterioration in the muscles and speed recovery. - Use analgesics like advil or aleve and muscle relaxants to relieve pain and muscle spasm, as needed. Vitamin B12 supplements & Pregabalin may be helpful in controlling the neuropathic pain. I hope this answers your query. In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out. Wishing you good health. Regards. Dr. Praveen Tayal. For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal