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CT Scan Said There Was A Problem With L5 Related To Pars Defect. Painful, Sudden And Intense. Concern About Narrowing Area?

Posted on Sat, 30 Jun 2012

Question: I have a quick question about an abdominal CT scan looking for digestive problems that found something wrong with my back. I only got a high-level quick explanation as to what was observed by the radiologist (per the nurse at my gastro's office, which had not yet been reviewed by my gastro). She stated that there was an issue on the L5 related to a pars defect (bilateral, anterior), Spondylolytic something or other. Anyway, as I've done a little research I see that there are different grades, and I do not know what grade mine was. However, I have my CT scan and I am pretty sure I can see where the issue is. I'm just wondering if you have any advice about the severity of this issue and any risks that I should be aware of. I have had several symptoms, all of which I had attributed to inactivity, such as lower back pain (sometimes so intense when I stand from sitting that I cannot straighten my back for a couple minutes), weakness in legs (not infrequently, but it can be sudden and intense where I feel like I could collapse), etc. I have added a screen print of the injured area (I think), and I am a little concerned about narrowing area around my spinal canal. Any help would be appreciated.

Answered by Dr. Krishna Kumar (6 hours later)

Hello,

Thank you for sharing your concern with me.

I have seen the screenshots attached with the query.

Pars defect in many instances is an incidental finding in patients with back pain. There are different grades of it, for which one need standing lateral x-ray with flexion and extension views. Pars defect may cause symptoms; as in your case getting up from sitting due to micro movement occurring at the site. If you would want to know further, you have to have x-rays and MRI of the spine.

Please remember, not all pars defect need aggressive treatment. Most of the low grade patients tremendously improve with medicines and exercise programme.

Thank you.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Krishna Kumar (6 hours later)

Thank you so much for your reply. I did have a follow up question regarding whether you think the cord is being compressed in those pictures. I have many problems in my cervical spine, e.g. Bulging and herniated discs, bone spurs, disc degeneration, etc. I decided that the criteria I will use to decide whether I'll follow through with surgery is when and if there is ever any cord compression observed or the pain is so intense I cannot deal with it. And at this point it hasn't met either. Therefore, I will use the same criteria regarding my back. After looking at the CT, it looked from those two screenshots that the defect that it is very close to the cord, as it is mashed and odd shaped compared to all the other images. That is my only worry. Do you believe this may be the case here? If it doesn't look like it is, I'll probably not worry about it much.

Answered by Dr. Krishna Kumar (12 minutes later)

Hi,

I understand your concern.

I have closely looked at the screen shots earlier itself. The shape that you have described as 'smashed and odd shaped' is actually normal image occurring at that level. We call this as 'trefoil shape'.

I do not see any significant cord compression at that level. I can assure of it. So do not worry.

Hope this answer is reassuring and allays all your fears.
If you do not have any further queries, please accept this answer and close the discussion. Yet, let me know if you need any further help.

Regards

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Above answer was peer-reviewed by : Dr. Prasad