Symptoms, types and treatment of spondylolysis
Spondylolysis — this term means "the resorption of the vertebra". In medicine, the definition used to describe defects in the structure of the handle L4 or L5.
This definition applies more to the field of radiology, the cleft in the ear-hook can be detected only when the x-ray of the spine. Clinical ways of spondylolysis is not detected.
Pathogenesis and clinic
Spondylolysis of the spine is considered a congenital condition, as it is diagnosed immediately after birth. In practice, physicians meet with splitting shackle L5 (fifth lumbar vertebra). Such localization causes lower back pain due to the fact that the anatomical features of the spinal column assume the maximum load when lifting weights on the bottom.
The Pathology in the lumbar spine occurs in 99% of all identified cases. In this case, the splitting of the pedicles of L5-85% of cases, and L4 – 10%. If there is evidence of both localization, the pathology is called bilateral spondylolysis of the spine.
As a rule, in children, the disease is not accompanied by clinical symptoms. This is because they do not pick up heavy objects.
The Main clinical symptoms of splitting of the handle L4, L5:
- lower back Pain
- Radiating pain in the gluteal region and perineum;
- Impossibility of full extension of the hip joint.
If the splitting of arches combined with spondylolisthesis (displacement of the upper vertebra relative to the underlying), it may be pinching the nerve roots of cauda equina (the lower part of the nerve plexus in the sacrum). Clinical symptoms in this situation are formed depending on the direction of displacement:
- Anticonvlusants – anteriorly;
- Retromoderated – posterior;
- Laterosternites – in the lateral plane.
The Most commonly spondylolysis with displacement arises at the level of L4 and L5 vertebrae, due to severe physical stress on this area when walking and lifting.
Mainly the clinical picture of the disease occurs because of infringement of the nerve fibers in the lumbar-sacral plexus or nerve roots in the area "horse's tail". This leads to:
- Pain syndrome in the lower back, buttocks, lower extremities and perineum;
- the Violation of sensitivity of skin;
- Pathology of the pelvic organs (frequent urination and defecation).
depending on the causes of the disease can be divided into:
Functional spondylolysis often occurs in young people who are actively engaged in weight lifting.
Dysplastic type is congenital and is due to congenital malformations of the fetus or a bad heredity.
Reloading the view seen in athletes who have not kept back for sporting achievements. Against the background of lifting heavy dumbbells or pull the stem of the shackle L5 vertebra can not withstand static loads and cracking.
depending on the location of the slit there are the following types of pathology:
In typical form, the cleft arch is localized in the gap interarticular. When retrocomputing is in the root arc. Atypical localization of the joint between the slot and the base of the vertebral arch.
Treatment of spondylolysis of the spine is determined by the cause of the disease and its clinical manifestations.
If the cleft has sklerozirovanie region (overgrown by connective tissue), it is difficult to guarantee the restoration of the integrity of the pedicles of vertebrae L4 L5 or even after surgery. This is because bone tissue in sclerosis loses the tendency to recovery. The operation in this situation is just to eliminate the neurological manifestations of the disease (pain in the lower back, buttocks and crotch).
Good chance of effective treatment is a disease that is accompanied by increased accumulation of radioactive substances (cesium) in the field of bone tissue damaged bow. This suggests that the bone has a good regenerative capacity. In this case the treatment of spondylolysis of the spine is carried out with the use of rigid corsets like Boston.
symptomatic when the disease doctors recommend:
- non-Steroidal anti-inflammatory drugs to relieve the inflammatory changes of soft tissues;
- Muscle relaxants to decrease muscle spasms
Self-treatment pathology shouldn't be done, because in most cases it ends up in a L5 radiculopathy (pain and impaired sensitivity along the segmental nerve, passingbetween 4 and 5 lumbar vertebrae).
surgical methods most often when spondylosis of spine surgery Gil or its modifications. The intervention consists in the posterolateral access to the area of damage to the pedicles of the vertebra L4 or L5 to secure the discrepancies between different parts of the arc. To mobilize apply metal screws and beams.
Despite the high effectiveness of surgical methods in most cases, the conservative treatment of the disease. It involves wearing a special support corset and bandages.
To prevent neurological syndromes follows:
- Avoid physical exertion;
- Taking anti-inflammatory medications;
- Drink tools to improve the circulation in the spine.
unfortunately, spondylolysis over time leads to deformation of the spine, so you need to carefully monitor the disease and implement the recommendations of the doctor throughout his life.