Spondylolisthesis (spondylolysis) in the lumbar and cervical spine
Spondylolysis and spondylolisthesis of the lumbar spine
The human body has one important and unique feature. Is the ability to walk on land rising to her full height on two legs.
This feature allows the person to stand out in the living world is the backbone, the spine. On how healthy this part of the skeleton, depends very much.
Its structure of bone and ligamentous elements – all this allows the ridge to be stable and carry us on the ground.
If the ridge or its structure there is a defect or damage, it will inevitably have problems with health.
For example, existing problems in the lumbar backbone lead to lumbar pain.
The presence of gaps between the joints of the spine will be the cause of the disease spondylolysis. Most often it refers to the fifth leg of the arc of the lumbar or the so-called spondylolysis l5.
This disease causes the delay in development of the spine. What what is spondylolisthesis of the spine?
In the presence of such a defect from both sides, can cause slippage of the ridge ahead. This disease is more serious and is called Spondylolisthesis.
The most common spondylolisthesis of the cervical spine.
To date, this disease occurs in 6% of the population. At a young age, the number of patients among women and men identical.
But in older age, approximately after 20 years, the disease often manifests itself in men.
The causes of the disease
In today’s world, such diseases as spondylolysis of the spine is most often found in athletes.
Since the constant load of the same type lead to so-called «meltdown» bridge – interarticular portion of the spine. So «melting» in the case of irreparable breach called «fatigue fracture».
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First, this part of the joint is the link between all joints of the ridge and it provides the flexibility of the human body. The more is the load, especially in the training of athletes, the greater the probability of occurrence of this disease.
What is incredible is the fact that quite a long time, the body itself restores interarticular tissue preventing damage, but with constant exposure attempts of the body weaken and «break».
It is not a congenital disease, but in children it manifests itself at an early age. It is for this spondylolysis in these cases is called a congenital condition.
But in the case of children the disease has no complications, since children do not lead a busy life, which involves working with heavy objects.
Our body, namely the spine, are arranged in such a way that the main load when carrying heavy loads falls on the lumbar. That is why, the disease relates to its individual parts (less the fifth and fourth lumbar vertebrae).
Basically the classification depends on the offset, that is, the direction in which the shifted joint:
- Anticonvlusants is formed by the displacement or «slippage» of the vertebrae top to bottom, as if bulging forward. Yet this bias is called «anterior».
- Retromoderated means the same, but here the offset is «backwards».
- Laterosternites, more serious version spondylolysis when the shift occurs in the lateral plane.
For the most part all types of bias can lead to complications and clinical nature. This is due to the fact that trapped nerve, leading to undesirable consequences.
The degree of pathology
There are the following degrees of offset:
- First degree. Indicated in case of slippage on a quarter plate.
- Second degree — at the half.
- Third degree — a third of the plate.
- Fourth degree — if the plate is shifted by more than a third.
The degree of offset can be seen by making the x-ray side.
The types of this disease depend on:
- the causes of the disease, including physical characteristics, origin spondylolysis;
- the physical characteristics of the offset.
Thus, we need to consider only two characteristics define this disease. So, causes are not physical in nature spondylolysis are:
- the congenital nature of the disease is not dependent on loads and growing due to the fact that in the process of formation formed in bone joints which make up the arc of the spine;
- acquired is formed in the result of the action of external factors, but also due to injuries.
On the pathogenesis of separately distinguish the following types:
- functional (manifested in young active people lifting something heavy);
- dysplastic (it may occur due to improper development of the fetus or the presence of pathogens in the family of the person);
- handling (inherent in the people who are engaged in professional sports).
So, in addition to the offset, which we reviewed earlier, determine the pathology of the location of the cracks:
- a typical gap is formed clearly in the interarticular gap;
- atypical – a gap is formed between the joint slot and the base of the vertebral arch;
- retrocognitions – formed in the region of the root of the arc.
As the disease can be single or double — sided, stable and unstable. But in any case it is a reversible process.
As we have previously described, most often occurs in violation of the fifth lumbar spine.
Slightly rarer is the case with the fourth. In medicine, they represent spondylolysis and spondylolisthesis L5 and L4, respectively.
According to the statistics of all detected cases of lumbar 95% spondylolis affect the lumbar spine .
In other cases, it applies to other parts of the spine, such as cervical.
How to spot the disease
Spondylolisthesis of the lumbar spine has these symptoms:
- pain in the lumbar;
- the gradual spread of pain to the buttocks and crotch;
- problems with a hip joint;
- with the pinching of the nerve endings may cause the violation of the sensitivity of the skin;
- increase in urination.
But unfortunately, these symptoms are present in other diseases of the spine.
Mostly this disease is detected by chance in the survey and at the stage of gradual development of spondylolisthesis.
Diagnosis of the disease occurs in several stages. The first stage involves a conversation or a survey of the patient by the attending physician.
In the second stage, the doctor examines the patient to determine the pain areas of work of nerve endings, as muscle mass. And also, during the inspection of the study is pain synrome – enlarge when performing simple actions.
Under the third phase refers to the direction of the patient for x-rays and if possible MRI. These surveys provide a «picture» of the spine and need treatment or simple prevention.
Treatment of disease — tasks and techniques
Let the goals and objectives of the treatment of spondylolisthesis of the lumbar and cervical spine.
Goals and objectives
The main purpose of all methods of treatment used in this disease is the restoration of the functions of the spine in full.
In connection with the purpose of treatment and course of the disease is marked with the following tasks:
- restore flexibility of the spine;
- the strengthening of the restored tissues;
- the recovery of fractures, if any;
- prevention of recurrence of the disease.
In medicine today there are several approaches to the treatment of this disease:
- konservativnyi methods;
- rehabilitation therapy;
For example, for restorative therapy you need a referral to a doctor-physiotherapist. A correctly written program of treatment helps to reduce pain, inflammation, restore flexibility and mobility range.
Medical treatment is prescribed in rare cases and only to relieve serious pain.
Often, to avoid surgery, the doctors prescribe rest which exclude physical activity, besides wearing a special corset to relieve the pain syndrome and acceleration right crasivaia tissues.
Addition to conservative treatment may be the above-mentioned therapy and medication.
Any surgery involves intervention in the functioning of the organism, is rather dangerous for patient’s life and therefore rarely used.
As with any spinal surgery is unsafe because of the fact that there is spinal cord – this method is used in very rare cases.
Complications can occur as a result of constant sport, injury and damage.
In addition, this disease may gradually develop spondylolysis spondylolisthesis – a spinal deformity.
And in this case, the necessary and the only solution is surgery..
To exclude recurrence of the disease and its prevention it is necessary to observe following rules:
- to limit the load on the spine;
- to take medications that prevent inflammation;
- to take drugs to improve circulation of blood.