The Spine
The spine needs to be rigid, yet also needs flexibility of movement. Meeting these requirements demands a complex structure.
Pars Defects and Spondylolisthesis
These two conditions are related and are quite common, being present in about one in twenty people.
Fortunately the problem usually causes no more than occasional mild back ache and most people never know that the abnormality is present. It may be picked up as a coincidental finding on x-rays.
We think that the condition is in fact acquired in infancy as a stress fracture which affects the link between the back part of the vertebra and the main body of the vertebra. This region is called the pars intra-articularis ('the part between the articulations') and the stress fracture, which commonly fails to mend, is then called a pars defect. It is usually, but not always, present on both sides. Sometimes the defect can cause pain and this commonly seems to be set off by a sudden stress or jarring of the back. The symptoms are often related to movement and activity and they can start to be troublesome at almost any age, from early adolescence to late middle age.
The separation of the back part of the vertebra means that the vertebral body is not properly restrained. The disc becomes over-stressed and wear and tear changes can start to develop. The vertebra can start to slip forwards a little. This is called a spondylolisthesis. In addition to causing problems of back pain as the vertebra slips forwards, it can drag on the nerve roots causing sciatic pain in the legs.
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In memory of Nick Boeree
Following the sudden death of Nick Boeree we have set up a tribute page to allow you to share your memories, thoughts, and feelings. Click here.
Everything just clicked into place! All the uncertainties, the muddle and the contradictory advice we had received before, just dropped away once we came along to see you. Very quickly we got the answers, the information and the treatment my wife needed.
John Temple
