33yr male w pars fractures on both sides of l5, pain from l5 root nerve, facet injections and epi did not help, how do i know if i need surgery?high pain

Common.: Most of people with fractures if the pars have no symptoms, although slippage of one vertebra over another can, and pars defects causes this condition called spondylolisthesis. Most grade 1-2 cases need no surgical issues. Grade3 & 4 do cause neurological sx. Speak to a qualified neurosurgeons or orthopedic spine surgeon to discuss!

See below: Failure of conservative treatment is an indication for surgery. If you cannot live with the pain or have weakness, surgical options would be appropriate.