Young athletes who play contact sports are at risk for a debilitating back injury, a pars fracture.
Nick Mucerino's passion for hockey was at risk.
"My mom took me to a lot of the games and I kinda just developed a love for the sport."
But after a big hit on the ice, the 16-year-old started feeling severe pain in his lower back.
"The way I can describe it is somebody taking an ice pick down your spine."
Nick suffered a pars fracture.
"The pars is a part of your spine. It can be fractured after repetitive stress and strain, particularly after sports," explained Dr. Allan Levi, University of Miami neurosurgeon.
It is usually a stress fracture rather than a sudden break.
It's a common injury in young athletes who play football, soccer, hockey or ballet.
Active kids and teens with spondylolysis may experience symptoms.
However, some people with this condition may not develop symptoms until later in adulthood.
"In fact, some of the fractures will actually heal on their own," said Dr. Levi.
Dr. Levi says patients who have a lot of arthritis of the spine are not good candidates.
But when Nick's injury didn't improve after six months of physical therapy, he was offered a unique procedure.
"It's a technique where you basically use a minimally invasive approach to put screws across the fracture site," said Dr. Levi.
X-rays may miss initial diagnosis.
He recommends doctors perform a CAT scan to see the fracture.
Dr. Levi developed the procedure, that uses two small incisions.
"We put a pin through the fracture," he said.
"Then we get an intraoperative CAT scan to make sure the pin is exactly where we want it to be."
Screws are placed across the fractured bone to promote fusion.
Six months after his surgery, Nick was ready to get back on the ice.
Now enrolled in law school, he still loves to get in the rink and play.
His back pain is gone.
"It hasn't limited me in any way."
Dr. Levi says there is less blood loss and less dissection of the spine muscles so patients have less pain.
Most patients go home the next day after surgery and undergo about three months of physical therapy.