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Is surgery required for my unstable spondylolisthesis?

I recently did something that caused full blown sciatica. After a couple weeks almost gone away when I triggered it trying to mount my bike. After another 2 weeks it was almost gone when I triggered once again picking up my shoes. I went to a spine Dr and he ordered PT and an  X-Ray.  After a few weeks the PT has cleared my symptoms except for some toe numbing in my right leg. However, the X-Ray came back with level 1 spondylolisthesis at L5/S1 with instability (3mm bending backwards and 6mm when bending forward). I have an MRI scheduled in couple days. From what I can read on the internet and indications from my Dr's assistant unstable spondylolisthesis will almost for sure require L5/S1 fusion. I am just wondering if my PT has a chance to solve my problem. I should note, my PT upon reviewing my original symptoms indicated he thought I had a SI joint mis-alignment as well and has been treating both.
1 Responses
973741 tn?1342342773
Hi.  I actually think doctors around me do not immediately go to surgery.  They start with non surgical attempts and often it is healed this way.  I had something similar with a him as you describe.  I'd start to get better, it would then get wrecked again with a slight movement.  However, it's now been over 6 months, knock on wood.  Seems to be fine.  Feels so dumb when you end up with a long standing issue to deal with by just walking through your back yard and getting your heel stuck in a hole  like I did.  Ya, that sounds stupid just saying it.  But that's what happened and then it was all sorts of small movements after that which kept re agitating the injury.  I would strongly recommend a physical therapist.  They can do a heck of a lot to get us back in action.  They help strengthen, stretch and heal.  They use heat and massage too.  Sometimes steroid shots are given.  But I'd personally always try this before going the invasive surgery route.  Here's a study to look at. https://journals.lww.com/clinorthop/Fulltext/2006/02000/Treatment_of_Instability_and_Spondylolisthesis_.30.aspx
3 Comments
Thank you very much.  PT has been great.  It turns out I have fractured pars and my type is Isthmic Spondylolisthesis.
ouch.  PT does do a tremendous amount of good.  Is it getting any better with this type of therapy? Do you wear a brace?
Yes I feel much better but that is probably the herniations fading. Not sure about the Spondylolethesis.  No brace. Just PT.
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