Pars Fracture

A Pars Fracture is a breakage of the pars articularis, a bony point of contact between two adjacent vertebrae. Vertebrae make primary contact through the intervertebral discs that act as shock absorbers on the spine. The facet joints of which the pars articularis is part protect the spine from the shearing forces to which the discs are susceptible.

CONDITIONS EXPLAINEDPars Fracture

CONDITIONS EXPLAINEDPars Fracture

A Pars Fracture is a breakage of the pars articularis, a bony point of contact between two adjacent vertebrae. Vertebrae make primary contact through the intervertebral discs that act as shock absorbers on the spine. The facet joints of which the pars articularis is part protect the spine from the shearing forces to which the discs are susceptible. When the pars articularis is damaged from excessive or repetitive stress, it may fracture and result in a loss of support for superior vertebrae. This commonly manifests with spondylolisthesis, in which the upper vertebra slips horizontally over the supporting one.

Fracture of the pars articularis occurs most commonly in the lumbar region, and especially in athletes who experience regular stresses on the vertebral column, such as gymnasts. In less severe cases, only a crack in the pars will occur, causing pain which may radiate to the extremities, but not yet leading to degeneration of spinal structure. Other common symptoms include numbness or tingling in the back, muscle spasms, and headache. Usually, medication and rest are all that are required for recovery from a pars fracture.

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A Pars Fracture is a breakage of the pars articularis, a bony point of contact between two adjacent vertebrae. Vertebrae make primary contact through the intervertebral discs that act as shock absorbers on the spine. The facet joints of which the pars articularis is part protect the spine from the shearing forces to which the discs are susceptible. When the pars articularis is damaged from excessive or repetitive stress, it may fracture and result in a loss of support for superior vertebrae. This commonly manifests with spondylolisthesis, in which the upper vertebra slips horizontally over the supporting one.

Fracture of the pars articularis occurs most commonly in the lumbar region, and especially in athletes who experience regular stresses on the vertebral column, such as gymnasts. In less severe cases, only a crack in the pars will occur, causing pain which may radiate to the extremities, but not yet leading to degeneration of spinal structure. Other common symptoms include numbness or tingling in the back, muscle spasms, and headache. Usually, medication and rest are all that are required for recovery from a pars fracture.

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Detection & Diagnosis

Detection of a pars fracture is a straightforward process involving several diagnositc procedures:

Physical Examination
Physical examination is the first step to diagnosis of a pars fracture, and essential to pursue early on to prevent the risk of complications.
X-Ray
X-rays are fast, safe, effective, and routinely used for imaging bone anatomy to visualize a pars fracture.
Bone Scans
Bone scans are an excellent modality for early detection of a pars fracture.
MRI
MRI may be performed to visualize softer nearby structures, such as discs and ligaments.
CT Scan
CT scans allow for the imaging of healing bone and evaluation of a pars defect.

OUTCOMESRelated
Treatments & Procedures

In most cases, non-surgical therapies will be adequate for the treatment of pars fracture. Medication, rest, and bracing may be used to facilitate the recovery process. One can expect recovery to last three to four months, and physical therapy may be pursued to help strengthen compensatory structures.
If conservative treatments prove ineffective, surgery is an option to treat persistent pain. Some of the more common procedures performed include:

  • Laminectomy, a form of spinal decompression surgery in which a portion of the vertebra including the pars articularis is removed to reduce pressure on underlying tissues.
  • Posterior lumbar fusion may be employed in cases of vertebral instability to fuse two vertebrae together, thus returning stability to the spinal column. Therapy will typically last for 6-8 weeks following this procedure, but full recovery may take up to 6 months.
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Anterior Lumbar Interbody Fusion

Anterior Lumbar Interbody Fusion (ALIF) is a procedure performed from the anterior to fuse vertebrae into a single structure. This technique is usually favored when..

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Artificial Disc Replacement

Artificial disc replacement is a procedure with the goal of removing a painful intervertebral disc and replacing it with a prosthetic one. Spinal fusion is much more commonly performed..

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Decompression (Laminectomy)

Decompression Lumbar Laminectomy is the most common surgical procedure performed for the correction of stenosis in the back. The surgeon will remove or trim the bony lamina and a thick ligament..

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