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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.
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.
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.
Spire Harpenden Hospital
(01582) 714 304