Age: 16 (At time of treatment)
Profile: Enthusiastic all-round sports person, and National league Basketball player.
Diary of events:
May 2007:
Mid-way through May I was participating in a PE lesson, playing a game of baseball. I was eager to repeat something I had achieved earlier in the year, hitting the ball out of the school. On this occasion the ball hit top of the fence. On my way round the bases I felt a very slight tweak in my lower back, I thought nothing of it, and carried on running. Whilst getting changed after the game, my back began to feel stiff and uncomfortable. The next day I woke up with mild discomfort, but noticeable nonetheless. I participated in basketball training that night, and continued to do so for the next couple of weeks, until the end of the season, experiencing noticeable pain.
June 2007:
The pain continued. I went to my GP, which resulted in an x-ray, and being referred to physiotherapy locally. Weekly visits and carrying out a series of exercises every day, soon it became clear that this treatment plan was not going improve my condition enough, to allow me to play basketball pain free, if at all. The results of the x-ray were not conclusive, but did highlight, “ a thinning of the pars”.
July - August 2007:
Another visit to my GP, and a referral to a spinal specialist, he suggested a period of 6-8 weeks rest and sent me to physio for core strengthening exercises. It was also arranged that I would have a CT scan on my lower back. Towards the end of the month I went with my father to discover the result to the CT scans, unfortunately our worst fears were confirmed. I had a pars inter-articularis fracture on both sides of L5.
September 2007:
An MRI scan was arranged mid month, to confirm and establish the integrity of the disc between S1 and L5, fortunately it was in good shape.
A further appointment with the surgeon was made. My condition and pain despite the core strengthening exercises had not improved. The surgeon explained if I wanted the operation, he would fix L5 to S1 (fusion), consequently loosing 20% of my lower back mobility – if this wasn’t bad enough there were worrying risks. These included potential urinary and bowel problems, and an estimated 12-month recovery. He indicated that sport for me was probably over, and this was confirmed by much of what was read on the Internet. My first question was “when can the operation be done” believing I would still be able to play basketball, however after many in depth conversations with my dad and much research we decided to get a second opinion.
October 2007:
I went to see a family friend, Consultant Surgeon Alistair Wilson OBE. After examining me, viewing both CT and MRI scans he suggested that I see one of his colleagues as the best person available to help me, Coiln Natali, Consultant Orthopaedic and Spinal Surgeon.
A short time with Mr Natali bought a massive relief to both my dad and I, in just a few minutes the whole situation had changed. I had been referred to back2normal for aggressive physiotherapy, in the first instance, then a much less intrusive operation should the need arise, with a short recovery time and very much less risk - The journey home was just wonderful!!! A few days later a letter arrived from Mr Natali confirming our conversation and his treatment plan, as you will see below worked just as he said!
I started physiotherapy at back2normal near London Bridge; TJ, Senior Physiotherapist designed a programme to get my core strength up to a level that may have stabilised my lower back negating the need for surgery. After 4 weeks of intensive core strengthening exercise it was established that surgery was the only option if I wanted to continue with sport at a high level.
November 2007:
We (dad and I) met with Mr Natali and the date was set for the operation on 16th November 2007. I underwent surgery at 1 o’clock, 2 ½ hours later in a state of some recovery I was back in my room, still very sleepy. A rough night followed due only to my reaction to the anaesthetic. The following day I managed breakfast and negotiate 4 flights of stairs up and down un-aided. The bone pain that I was experiencing before had disappeared, although the wound was a little sore. Just 24 hours after the operation I was told that I could go home, and I did.
Over the next few days, to relieve the minimal pain I took ibuprofen. The weeks to follow were frustrating. I was walking very rigidly and tentatively. My mobility was improving daily as was the healing, and my confidence. There was moderate swelling around the wound area as well as a neat 2-½ inch scar.
12 days after the surgery I was returned to school.
Two weeks after the operation I returned to see Mr Natali, travelling by rail, walking comfortably to and from the station. Mr Natali removed the dressing and what remained of the dissolvable stitches. My general progress was pleasing, and the soreness that I was experiencing from the scar area was reducing day by day.
Four weeks on another visit to Mr Natali, I was x-rayed on arrival. The image confirmed that all was well, no movement in the repaired area and the grafting was taking, as expected.
Next follow up, 28 days later, Mr Natali allowed me to return to sport, on the condition that I was careful, and I was. The success of the procedure left me with my fitness being the next priority a difficult hurdle to overcome.
April 2008- so how is it now?
Five months after the operation I have just returned from a Euro-basket international basketball camp in Malta. This consisted of morning offensive workouts lasting 2 hours and then 2 hours worth of games in the afternoon, separated only by individual gym workouts. There was not the slightest trace of the bone pain that was once experienced; I am now about to start my off-season training.
February 2009
All is well, training 5 nights a week, and playing matches at weekends, and now hoping to go college in America to further my studies and basketball career.
I am indebted: to many people for my tender years, my family - without their love dedication, time and commitment I would not have achieved the success to date in the sports I enjoy so much. My Instructors, Trainers and Coaches for their time and commitment in supporting me and imparting their knowledge (you know who you are). My Dad, without his tenacity in researching the condition I had, and not accepting the first surgeons’ method of repair things would of been very different. Our family friend - “Dr Alistair” - Alistair Wilson OBE (Consultant Surgeon and founder of the Helicopter emergency service - HEMS) for helping me when I thought there wasn’t an acceptable way forward, and for referring me to, Mr Natali, TJ of back2normal for his confidence and professionalism in building a training programme that strengthened my core, which undoubtedly contributed to my remarkable recovery, and for getting me ready for competitive sport once again. And of course Mr Natali for his humour, confidence and phenomenal skill in repairing the Pars defect so successfully.
Thank you all so much.
