The symptoms and treatment of spondylolisthesis of the lumbar spine
Treatment of spondylolisthesis of the lumbosacral spine performed initially by conservative methods. If they do not bring the desired effect, the doctors resort to surgical methods.
what is conservative treatment
spinal Fusion L5 – the most common kind of displacement of vertebrae in the spine. If it occurs in young people under the age of 25 years, the doctors are trying to eliminate pathology of conservative methods.
What are the medical methods used to treat spondylolisthesis in the lumbar spine:
- anti-Inflammatory therapy;
- the Wearing of orthopedic corsets;
- Stabilization of the vertebrae (chiropractic, massage, osteopathy);
- exercise therapy.
When spondylolisthesis L5-S1 is contraindicated stretching (traction). This method is accompanied by stretching of the muscular-ligamentous apparatus of the back, expansion space between adjacent vertebrae, which causes further displacement of the vertebrae in the affected segment of the lumbar spine.
The Complex of conservative treatment begins with anti-inflammatory drugs. To resolve inflammation and pain prescribers group of nonsteroidal anti-inflammatory drugs (NSAIDs).
When the pain intensity is reduced, and the complex therapy supplemented by fiziolechenie: warming of the spine, magnetic therapy, mud treatment.
The Wearing orthopedic corset supports the affected segment of the spine in the correct position, which prevents further displacement. The patient must remember:
- the Corset is worn in an upright position;
- with the sleep removed the product;
- the Time of dressing should coincide with a period of physical exertion;
- If you are experiencing pain, you should consult a neurologist.
In the presence of displacement of vertebrae in the spine patients should change their lifestyle. Devote too much time to walks on fresh air, which will help to restore the blood supply to the spine and reduce painful symptoms in the lower back and lower extremities.
If the pain persists NSAIDs (diclofenac, dicloberl, voltaren, ibuprofen), doctors spend novocaine blockade or injection of steroid hormones. This method allows to reduce the intensity of the pain symptom in the lumbar spine by 50%, but it should be understood that it can be used not more than 3 times a year. At the same time between treatments should be a break of a few months.
When surgery is required
When spondylolisthesis L5 S1 grade 3 and 4 – operative treatment. With 2 degrees of pathology, the operation performed when no effective conservative therapy or medically impossible to remove severe pain.
Surgical intervention when the disease shows when you experience symptoms of concomitant pathology of the kidneys and intestines, which can be complicated on the background of compression of the spinal nerves in the vertebrae listesi.
When the slipping of the vertebra there are neurological symptoms, which can lead to disability:
- Heaviness in the leg;
- Numbness of skin;
- cauda equina Syndrome
- weakening of the reflexes.
surgical treatment is aimed at stabilizing the displaced vertebrae by installing artificial implants and fixators. The surgery is called laminectomy. It is held under the following types:
The Most perspective is considered to be the left rear mini-access (extraperitoneal). When it is damaged the minimum amount of tissue that allows the patient to quickly return after a rehabilitation period of physical activity.
In our country the surgeons popular laminectomy with fixation of the vertebrae with titanium screws that are inserted through a vertebral arch. The operation is called transpedicularly.
The First method was applied in 1963, Roy-Camille and since then is actively used in our country.
In Europe, the surgical treatment of spondylolisthesis by individual structures with bone grafting:
- Interbody fusion involves the use of titanium plates and autologous bone. The method is applied in patients with acute neurological symptoms when the displacement of the vertebrae at the level of L5-S1;
- Transpedicular fixation with interbody fusion is accompanied by a short rehabilitation period, but the operation takes about 6 hours. In the process of executing the procedure should be turned several times to the patient on the surgical table;
- Circular spinal fusion is performed through extraperitoneal mini-access. The procedure is less traumatic, but is characterized by a long rehabilitation period.
Spondylolisthesis in the lumbar spine at the level L5-S1 without surgery is quite difficult to eliminate. Even after surgical treatment pathology need rehabilitation exercises for a few months.
Physical therapy Exercises after surgery for spondylolisthesis L5 S1:
- From the supine position gently lift up the torso. Secure the hand rail wall bar and slowly lower down. Repeat the exercise 10-15 times;
- Follow the bending forward, placing the foot on the step 3 of the Swedish wall. Try to touch his head straightened legs;
- Position your torso at an angle of 30 degrees on an incline bench (lying on back). Download press for 3-5 minutes.
Remember! In the initial stages of rehabilitation exercises after surgical treatment of spondylolisthesis of the lumbar spine (at levels L5, S1) should be performed slowly. Its intensity increases from one activity to another.
In conclusion, I would like to add: spondylolisthesis of the lumbosacral spine is a serious pathology, which without proper treatment will lead to disability.