Pediatric Pars Repair · Patient Story
Back on the Field After Pediatric Pars Repair
After months of unresolved back pain threatened 16-year-old Nathan Young’s soccer career, the right diagnosis and a motion-preserving repair gave him a path back to competitive play.
Nathan’s Treatment at a Glance
A Motion-Preserving Path Back to Soccer
Nathan’s back pain persisted for months before imaging revealed bilateral stress fractures in his L5 vertebra. After conservative treatment failed, Farah Musharbash, MD, recommended a minimally invasive repair designed to stabilize the fractures without fusing Nathan’s spine.
A 16-year-old competitive soccer player with persistent lower-back pain that increasingly limited his ability to play.
Minimally invasive, robotic-assisted direct pars repair performed by Farah Musharbash, MD .
Complete bony healing was confirmed at three months, and Nathan was cleared to return to competitive soccer.
Explore Nathan’s Pediatric Pars Repair Case Study
See the imaging, surgical rationale and minimally invasive technique behind Nathan’s motion-preserving bilateral L5 pars repair.
When the Pain Didn’t Go Away
Five Months Without the Right Diagnosis
Nathan was training twice a day and competing with elite soccer programs when a slide tackle on wet turf changed everything. He over-rotated and felt a sharp pain shoot through his lower back—but finished the game because he did not want to lose his starting position.
Initial X-rays appeared reassuring, and Nathan and his mother, Nadienne, were told the injury was a sprain that should improve with physical therapy. He followed the treatment plan, fitting therapy around school and training, but the pain continued.
Because they believed the problem was muscular, Nathan kept trying to play. During a later game against one of the country’s leading youth teams, the pain became so severe that he could not finish the first half.
Additional X-rays and a CT scan still did not provide an answer. Finally, an MRI performed five months after the original injury revealed bilateral stress fractures in Nathan’s L5 vertebra, along with a stress reaction in his right hip.
Nathan had a pediatric pars fracture, also called spondylolysis —an injury frequently associated with sports that repeatedly place the lower spine into extension and rotation.
“We had been told for months that Nathan’s pain was muscular. Then suddenly it was, ‘You fractured your spine, and you’ve been playing on it.’ That was really scary.”
— Nadienne Young, Nathan’s mother
Finding the Right Specialist
A Second Opinion Changed the Direction of His Care
Nathan and his mother left their first spine consultation uncertain about what should happen next. Nadienne began looking for a specialist who treated pediatric spine conditions and understood the demands of a competitive athlete.
When she contacted Atlantic Brain and Spine, Farah Musharbash, MD, had an opening the following day. For Nathan, the difference was immediate.
“I liked the fact that he was talking to me, man to man, doctor to athlete. All the other doctors talked to my mom.”
— Nathan Young
Dr. Musharbash evaluated both the fracture and what Nathan hoped to return to doing. The goal was not simply to relieve his pain—it was to choose a treatment that considered the rotation, acceleration and rapid changes of direction required in competitive soccer.
- A treatment plan based on Nathan’s imaging and response to conservative care
- Direct communication with Nathan as both the patient and an athlete
- Consideration of motion preservation and his long-term athletic goals
Why This Procedure
Repairing the Fracture While Preserving Motion
Most pediatric pars fractures heal without surgery. When Nathan’s fractures did not heal with activity modification and physical therapy, Dr. Musharbash recommended a direct pars repair designed to stabilize the injured bone while preserving movement in the rest of his lumbar spine.
Repair the Injured Area
Direct pars repair targets the fractured portion of the vertebra rather than treating a larger section of the spine.
Avoid Spinal Fusion
The procedure was selected to stabilize Nathan’s bilateral L5 fractures without permanently joining adjacent vertebrae.
Protect Future Movement
Preserving lumbar motion was especially important for a young athlete whose sport requires rotation, speed and rapid changes of direction.
Minimally Invasive, Robotic-Assisted Bilateral L5 Pars Repair
Twenty days after meeting Dr. Musharbash, Nathan underwent bilateral L5 pars repair at Overlook Medical Center. Using robotic navigation, Dr. Musharbash performed the procedure through small incisions in less than an hour.
Nathan returned home the same day. His procedure represented New Jersey’s first outpatient, minimally invasive pediatric pars repair performed with robotic guidance.
Looking for the surgical technique, clinical decision-making and imaging? Nathan’s clinical case study provides a more detailed view of his diagnosis and repair.
View the Clinical Case StudyRecovery in Motion
From Pain-Free Walking to the Starting Lineup
Nathan’s recovery followed a structured progression designed to allow the repaired bone to heal before gradually reintroducing the demands of competitive soccer.
Nathan’s Return-to-Play Timeline
- Immediately After Surgery
Nathan began walking and returned home the same day as his procedure.
- Three Weeks
He began intensive physical therapy focused on rebuilding strength and supporting a safe return to activity.
- Eight Weeks
Nathan was cleared to resume non-contact drills with the ball while continuing his rehabilitation.
- Three Months
CT imaging confirmed complete bony healing, allowing Nathan to begin his full return to play.
- Back in the Starting Lineup
On March 7, nearly 10 months after the original injury, Nathan played his first complete game in his starting position.
“After two days, I told my mom I wasn’t in pain anymore. It was the first time I hadn’t been hurting since May.”
— Nathan Young
Nathan is now pain-free and once again balancing school, training and competition. The time he spent rebuilding strength also helped him return to the field feeling stronger as he continues working toward his goal of playing soccer at the highest level possible.
What Families Should Know
Most Pars Fractures Do Not Require Surgery
Nathan’s procedure was recommended only after his fracture was correctly identified and conservative treatment had not allowed it to heal. The right treatment depends on the individual fracture, symptoms, imaging and goals of the patient.
Start With the Right Diagnosis
Pars fractures can resemble muscular back pain, and early X-rays do not always show the injury. Persistent symptoms may require a specialist evaluation and additional imaging.
Allow the Fracture to Heal
Many young athletes recover with activity modification, physical therapy, bracing when appropriate and a gradual return-to-sports program.
Consider Surgery Selectively
When pain persists and the fracture does not heal, direct pars repair may be considered for an appropriate patient as a motion-preserving alternative to spinal fusion.
Pediatric and Young-Athlete Spine Care
Get Answers About Persistent Back Pain
If your child or teen has ongoing lower-back pain, a diagnosed pars fracture or symptoms that return with sports, our team can review the diagnosis, imaging and available treatment options.
