​Pars Fracture

A pars fracture is a bony defect in a bit of bone on the lower back called the pars interarticularis. A pars fracture is also called a spondylolysis. The pars interarticularis is a part of a lamina. The lamina is the bony arch that forms the back part of a vertebra.


A pars fracture is often due to a stress fracture, which occurs as the pars interarticularis gets very thin when we are going through a period of rapid growth. This condition most commonly presents with back pain in teenagers bought on by exercise, typically exercise involving repetitive extension (arching) of the lower back. Pars fractures occurs in approximately 6% of teenagers, though more commonly seen in young sportsmen and women. There is an increased risk with sports that involve a lot of arching of the lower back, such as gymnastics, butterfly swimming, diving, and fast bowling. A pars fracture usually occurs at the L5 level in the lower back. A pars fracture can progress to a spondylolisthesis if it does not heal.

Diagnosis

A pars defect can be diagnosed by x-ray, MRI or CT scans. Whilst CT is the most reliable way of diagnosing a pars defect, we tend to use MRI first as is safer.

Treatment of Pars Fractures

The initial management of a pars fracture is a period of rest and complete abstinence from all sport and physical exertion. This is followed by trunk and abdominal strengthening exercises, guided by a physical therapist, and a gradual return to sport.


Surgery is normally only considered if non-operative measures have failed to relieve your symptoms. A surgical repair of the pars defect may be sufficient in younger patients; in older patients or in those with some degree of instability, a fusion may be required.

What Patients Say

I would like to express my sincere thanks and gratitude for curing my pain. For months I have suffered in agony day and night. I was in despair and you were my last hope. Now I am not in pain! I am continually smiling and enjoying life again! March 2020

Mr Langdon was great from start to finish. I know that he saw me at the end of an already full clinic and on top of that arranged an immediate MRI…making him much later than he needed to be in getting home! I was in a great deal of pain and I very much appreciated his help in getting me sorted as fast as possible. He made sure I was early on in the running order of procedures on the day of my treatment and everything was explained well to me both before and afterwards. Cannot fault in any way. Thank you very much.

Very patient took his time explaining the surgery and aftercare. Very knowledge about my condition. Made me feel relaxed and in safe hands as I was very scared of the surgery itself and the possible risks.

Very caring, explained fully what was wrong and what he was going to do. December 2019

He was very professional and helpful before, during and after my minor treatment. December 2019

Mr Langdon was extremely helpful and reassuring. December 2019

Mr Langdon was clear and confident with his communication. This is reassuring for a patient. December 2019

Professional and treated to a high standard. Mr Langdon was excellent, he knew everything on my condition explaining all the options available. December 2019

Mr Langdon’s manner was very polite, professional and efficient, he answered all her questions and came to see her quickly after her epidural. June 2017

I have just completed a 102 mile walk over 7 days. Thank you so much for patching me up and making this experience possible. June 2017

Thank you for your specialist surgical and operational skills as well as your patient friendly approach. The two don’t always go together. We need people like you to maintain such high standards of surgery and care. October 2017

I wanted to take the opportunity to thank you and your team following my surgery. It has been so long since I felt so well and without pain. The surgery and my recuperation has far surpassed my expectations and has made a huge difference to my lifestyle. December 2017

Three months on from my back operation and I am feeling so much better. Thank you for all the kindness and support you showed when I was in such desperate pain. February 2018

Thank you so much for the work that you have done. What an incredible job you have and do. Life changing. March 2018

Thank you for all you have done for me during the last few weeks. I am most grateful not only for the main work but also the extras like telephoning to keep me informed. April 2018

I cannot thank you enough for the success of my back operation. Everyone was so pessimistic and you were so positive. May 2018

I was at all times given all necessary information, listened to, and I had confidence that Mr Langdon would complete the operation successfully. August 2018

Highly skilled and intuitive. October 2018

He was brilliant, I felt so comfortable that he would look after me even though I felt so anxious, and he made sure to give me all the information I needed. Also, every nurse and employee of Spire had nothing but brilliant things to say about Mr Langdon – I didn’t even need to ask. They would look on my notes and see I had Mr Langdon and say I was in excellent hands, and so I felt extremely happy. My partner also has disc problems so I will very much be pointing him to Mr Langdon October 2018

Very understanding and caring chap from start to finish, and a great bedside manner, unusual for some consultants. He is trying hard to understand my problems and working with me on a treatment plan for the present, and the future. November 2018

My consultant is obviously a very competent person and comes across as such. My procedure was fully explained both before and after my surgery. He also has a professional sense of humour, which helped as I was very nervous November 2018

Mr Langdon was always prepared to fully explain what was wrong and what he could do about it, he gave me a lot of confidence to make the decision to operate, and so far so good. Albeit early days. November 2018

Mr Langdon was very professional and helpful, he came in on his day off because my treatment had to be moved. November 2018

Excellent, extremely knowledgeable on his speciality. I managed to get an appointment to see him at very short notice for which I was very grateful. December 2018

Excellent surgeon, great manner, explained procedure well. December 2018

A good sense of humour, understanding and non-judgmental. They explained everything very clearly. January 2019

Mr Langdon, very professional and calm, did not push the treatment on me which I really liked, but advised and let me make up my own mind. January 2019

James Langdon is a really good person to have on your side. He’s smart, attentive and very dedicated. January 2019

I felt very safe with Mr Langdon, he fully explained the procedure, the risks and the recovery. January 2019

A very professional consultant. Showed great care and understood me as a person and patient. Saw me pre procedure and after in recovery room and own room. Visited again before going home in late evening and yet again first thing the next morning. It felt like I was Mr Langdon’s only patient which I know is far from the truth. Unfortunately, I am a nervous patient but could not have been in better hands. Many thanks January 2019

Explained everything in detail, understood my concerns, excellent bedside manner, very professional. January 2019

James Langdon is very patient – he answers questions and really listens to you and explains again if you haven’t quite got something. March 2019

Mr James Langdon was in every way, courteous, clearly good at his particular area of expertise, took time out every day to see me and check that all was ok. Was happy to answer any questions I had. April 2019

Mr Langdon was very understanding about my condition and talked me through every procedure that could help me get more mobile again. I was always at ease with him with his caring attitude. A true professional thanks. April 2019

Mr Langdon gave a full explanation of the procedure and what would happen and what to do afterwards. Perfect. May 2019

Fully informed by Consultant Surgeon and Consultant Anaethetist who put me at ease with procedure. May 2019

I saw Mr Langdon before I had the operation and he explained everything that would happen on the day of the operation. June 2019

Very attentive, understood exactly what I was saying and made me feel confident that what I was doing was the right thing. June 2019

Mr. Langdon gave you complete confidence that all would be well and that he was available if needed at any time. He showed kindness and consideration. June 2019

Calm, professional, helpful. July 2019

Everything went off so smoothly. So pleased that the operation was so successful & the next day I was able to walk around without pain. July 2019

In overall terms he was absolutely brilliant. Clearly he is a brilliant surgeon but also a wonderful and understanding human being who, whilst pointing out the risks involved in the operation, filled me with absolute confidence that if success was possible, it would definitely be achieved – and I am delighted to say that it was. He is certainly a hero to me! It was also abundantly clear that all the staff at the hospital have absolute confidence in him and hold him in the highest regard. August 2019

Excellent, he fitted me in with an early appointment and treated me extremely well. September 2019

Extremely helpful explained everything very clearly. September 2019

Mr Langdon has been very clear and concise about the treatment he would be providing and the possible outcome. He has a very professional manner and I felt very at ease with him. He provided me with lots of information and visited me numerous times after my operation to see how I was and to explain what was done and what I should expect. I would be very happy to see Mr Langdon again in the future should I have a need to. September 2019

Caring conscientious and totally professional in all respects. September 2019

Mr Langdon gave me the confidence to go ahead with surgery that I was very worried about. He is very professional and thoroughly explained all the pros, cons and side effects that could possibly happen. All of the above helped me to make a more informed decision. October 2019

James Langdon was the consummate professional. He explained his diagnosis in plain language that was easy to understand and interpret from a layman’s point of view. He was careful to manage expectations and clear about potential risks keeping them in perspective and proportionate to the circumstances. His manner was direct whilst always retaining a caring attitude listening to the patient and answering questions clearly; even taking time out to follow up with my wife whilst I was still in post Op recovery. Very thorough and I would highly recommend James. October 2019

Fully explained the treatment I required and the reasons why. I felt very confident I was in good hands. October 2019

Professional, inspires confidence. October 2019

He was very understanding explaining everything very carefully and advising me on altering medication for the procedure and when to restart normal regime. November 2019

He was courteous, listened, understood the issue very quickly. Explained everything well and was sure to confirm I understood and asked if I had questions. I didn’t feel hurried. He provided an effective and efficient service. I’d definitely recommend him. November 2019

Professional and approachable. November 2019

Extremely happy. Care was first class throughout the stay and looked after all my needs November 2019

Very approachable, caring, friendly, put me at ease. December 2019

Very approachable and knowledgeable. Felt I was in very safe hands. December 2019

Very professional throughout. December 2019

Mr Langdon diagnosed my problem, explained fully the options I had regarding treatment also all the risks involved if I chose to have an operation. Mr Langdon organised a scan to confirm his diagnosis, and explained to me prior to my operation all that was involved in the procedure. Post operation Mr Langdon visited me in my room to check on my recovery and gave me the opportunity to ask any questions on the operation. I am very satisfied with Mr Langdon and his team on my treatment. December 2019

My marks of 10 across all questions reflect my opinion of James Langdon. Brilliant in all respects, in particular his explanation to a non medical man of my problem and his solution. December 2019

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Spire Harpenden Hospital

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(01582) 714 304

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