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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Back pain after lifting heavy object, sharp pain in hip and lower back. CAT scan showed grade 1 Anterolisthesis. Had habit of long distance trail running and cycling. What is the procedure of treatment?

Hi Dr. Samuel I am a 50 year old man about 170cm tall and weigh 70kg. I have been physically active and involved in long distance trail running and cycling. I injured my back three months ago while lifting a sleeping child (about 45kg) from the bottom of a bunk bed to putting him on the top. I had a sore back afterwards that I had been working on towards strenghtening until a week ago when I felt pain (intensity 3-4 out of a scale of 10) in my right hip & lower back. I had a CAT scan last week that revealed that I have a grade 1 Anterolisthesis. My GP has recommended me for an Electromyogram ( EMG ) that is scheduled on Friday next week. He has also advised me to stop all types of excercises. In last five days the pain in the hip and right lower back has decreased in intensity to 1-2 out of 10. Can you please explain how is this injury treated and how long does it take in general to recover/rehabilitate? Will I be able to get back to my trail running and cycling? Please see below comments given in my CAT scan report: L5/S1: There are bilateral L5 pars interarticularis defects. The defect measures 1-2mmm. There is Anterolisthesis of 5mm (grade 1). Minimal poterior disc bulging without central canal or lateral recess compromise. There is L5 foraminal narrowing with flattening of the exiting L5 nerve roots concerning for impimgement. Small endplate osteophytes are evident. There is no facet joint arthropathy at this level. Minor sacroiliac joint degenerative wear is evident. The soft tissues have a normal appearance. CONCLUSION: bilateral L5 pars interarticularis defects with resultant grade 1 anterolisthesis. There is complete effacement to the L5 nerve roots within the foramina, flattened, a probable site of neural impingement. Thanks in advance. Rizman
Tue, 29 Apr 2014
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Orthopaedic Surgeon 's  Response
Hi Mr Rizman, stop all exercises and running. Grade 1 anterolisthesis can be managed conservatively with Lumbosacral brace, muscle relaxants. When acute episode comes down one can start back strengthening exercises. L5-S1 neural foraminal narrowing has to be watched by regular follow up with spine surgeon.
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