Don't Step On A Crack...

We all have heard that silly rhyme, right? "Don't step on a crack or you'll fall and break your back" Well, apparently, Sterling's been stepping on FAR too many cracks 'cause he has, quite literally, a broken back. A vertebrae actually; L5 to be specific. We've known about this little back issue for a couple years, but I didn't realize the full extent of it until about a month ago.

The story begins in December 2009 when Sterling started to complain of his back hurting. I thought he was just being dramatic and trying to get out of doing work. Well, he continued to complain so I finally agreed to call Dr. C. After having him do some bending and balance exercises he said he thought Sterling had spodylolysis (spon-dee-low-lye-sis).  Which, in simple terms, is a stresse fracture in a vertebrae. He referred us to an orthopedist in town and we had x-rays, MRI and a bone scan done. Sure enough, his L5 vertebrae had a fracture, which showed up as a "bright" spot on the MRI. The orthopedist had us get Sterling a custom back brace. He had to wear it everyday for 6 weeks. After that he did better for a couple months, but the back pain started again. Another 6 weeks in the brace and the same result. At that point the Orhtopedist said that we could try one more session in the brace, but if that didn't work there was really nothing else that we could do apart from spinal fusion. He didn't recommend doing that since Sterling was still young and growing and it could also limit his flexibility. So one more session and...still the same. I didn't even bother taking him back since we weren't going to consider spinal fusion.

Fast forward to October when Eddie had his appointment with an orthopedist at CMH. I mentioned Sterling and his back problems and she asked me if he'd ever been seen at CMH for it. I told her we'd only seen the orthopedist in town. She told me that Dr. P with CMH had done a lot with kids with spondylolysis and to get Sterling in to see him. So we set up an appointment.

At his appointment with Dr. P he started off by telling us that there were other options for treating spondylolysis other than spinal fusion. (Yipeee!!) He talked about bracing again for longer period with electric stimulation to encourage bone growth. If that wasn't feasible, which he didn't think it would be given the amount of time Sterling has had this, the next option would be to do a bone graft to reattach the broken part. He said that they have the most success with this when it's the L3 or L4 vertebrae, but it's still possible with the L5 vertebrae. Finally, if that wasn't possible we could do a spinal fusion but only if Sterling was in so much pain that he'd be better off with less flexibility. He sent us to have a CT done to see how the fracture looked. Now, in my mind, I'd been thinking it was just a stress fracture, or small crack in the vertebrae. I was SHOCKED by what I saw in his CT!

We came back to the room and Dr. P came in and showed me CT results. There was a complete break of the back part of the vertebrae with a large gap.

Side View

Top down view

This was not good news. There was no way that bracing would help and the gap was just too large to even attempt a bone graft. So we were back to spinal fusion as the only permanent fix for it. On top of that, Sterling is also at a greater risk of developing spondylolithesis. That is where one vertebrae slips forward over another causing displacement of the spine and nerve damage...which, apparently, is a bad thing. Go figure. At this point he hasn't developed that and as he only has occaisional back pain, we are just monitoring his condition. Every 6 months or so he will have to go back to check his back and make sure it hasn't slipped. If he makes it to 15-16 years old without any problems then chances are he will be fine and won't have to worry about spondylolithesis until he's in his 70's. If it does slip, then we won't have a choice but to have his vertebrae fused to prevent further, more serious complications.

So, how did this happen, you ask? We have no idea. This type of injury is usually seen in people who participate in highly repetitive sports like gymnastics or football. And Sterling hasn't had any serious back trauma that we can think of. Chances are it's just a developemental abnormality or perhaps a genetic predisposition to it. We really have no way of knowing for sure.

Well, there goes the illustrious football career we had planned for Sterling. ::sigh:: Now how will he make millions so that he can support Rob and I in the lap of luxury in our old age?