What is sacralization of l5 vertebra and how is it treated
In medicine "sacralization" is a fusion of the first sacral (S1) and the 5th lumbar vertebra L5. In the old days a man with the features of the anatomical structure of the spine was thought to be endowed with a divine gift.
Times have changed, and scientists have studied this phenomenon more thoroughly. It turned out that there is nothing "Holy" or "otherworldly" in the sacralization no.
Medical sacralization of l5 (an abnormality of the structure of the vertebral column) is not accompanied by visible changes in health, so long time unnoticed. Detected only when the x-ray lumbosacral spine (for example, in the presence of lower back pain).
Anatomical features of the sacralization
Anatomically between the 5 lumbar and 1 sacral vertebra in man is the strongest of the intervertebral disc. Its functions are:
- to Reduce the depreciation impact on the spine when walking;
- to Maintain a desired value of the field in the intervertebral segment L5-S1, through which important nerve trunks from the spinal canal, passing on the gluteal region and lower limb
- to Prevent nerves of the cauda equina (accumulation of nerve fibers in the lower part of the spine).
Owing To the special properties of the segment L5-S1 damage, including sacralization, increases the load on the upper lumbar segments (L1-L4). This function is usually the spinal column cope until then, until a person will start daily heavy lifting often to bend and unbend (for example, as a result of professional activity).
In such a situation at a certain point, the intervertebral discs L1-L4 can not cope with the assigned load, and have lower back pain due to compression syndrome (nerve root entrapment).
Types of intergrowths of vertebral segments
Involves the Sacralization of l5 transition to 5 lumbar vertebra in sacral fusion by partially or completely with S1.
The Sacralization of l5 may be of the following forms:
- Full – fully merge all the structural elements is between l5 and S1;
- Partial vertebrae fused handles or spikes, which limits their mobility;
- Deep – this form stands out only by some scientists and involves the deep penetration of l5 in the sacral area without visible signs of fusion between the vertebrae.
depending on the peculiarities of the anatomical structure of the sacralization of l5 is classified into:
- is False.
The Above forms of spinal pathology are true sacralization. The false view appears in pathological processes, when there is ossification (deposition of calcium salts) of the ligaments of the spine between l5 and s1. This situation is often observed in ankylosing spondylitis (ankylosing spondylitis), when there is calcification of almost all ligaments of the vertebral column.
This "pseudo-sacralization" and appears in old age, when due to age features observed a deposition of calcium salts into the ligaments of the lumbar-sacral region of the spine.
The sacralization of the True from the false can be distinguished on the basis of x-ray pictures of the back according to the following criteria:
- When the intervertebral gap it is completely "shaded" by bone tissue;
- Poorly differentiated (or missing) the shadow of the spinous processes of the L5 and S1 vertebrae.
Sacralization is characterized by the appearance of the pain syndrome after the age of 25, when a man approaches professional activity. Other symptoms of pathology:
- Pain in the gluteal region and lower extremities;
- Loss of skin sensation in the thigh and in your lower back;
- Local pain on palpation along the spinal column;
- Limiting a circular motion of the lumbar spine;
- decreased mobility of the spine.
It Should be noted that the above symptoms appear only in severe pathology, when "squander" overlying the intervertebral discs in the lumbar spine.
Test for the assessment of spinal mobility is as follows:
- Stand up straight
- keep the Heels together and the toes spread to the sides;
- Try to get my hands on the floor;
- If this fails, ask a close person to measure the distance, which is lacking to the floor using the tape measure (from the end of the 3rd finger).
The Test for the mobility of the spine suggests the presence of sacralization, when clinical symptoms are not observed. Especially should be treated carefully to if there is a positive test in adolescents.
How to treat fusion L5-S1
In most cases, sacralization is a congenital condition. Fixit is a surgical procedure, but without the appearance of pronounced clinical symptoms, the operation is irrational. After surgery a person recovering physiological the number of lumbar vertebrae (5 pieces).
Conservative treatment pathology is based on the following principles:
- Massage Sacro-lumbar region;
- the Wearing orthopedic corset;
- Electrophoresis with novocaine;
- Ultrasound therapy
- anti-inflammatory Medication and painkillers.
During strong pinching of the nerve roots is only possible surgical treatment. It is aimed at the dissection of fusion between l5 and S1 vertebrae and the installation of a special graft substitutes for the intervertebral disk.
In Fairness it should be noted that the sacralization of l5 vertebra is rare in 2% of cases among all causes of lower back pain.