All about disc protrusion of the lumbar spine (l3-l4, l4-l5, l5-s1)

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Classic disc protrusion L3-L4 (loss of intervertebral disc without rupture of the fibrous ring between the 3rd and 4th lumbar vertebrae) leads to the appearance of acute clinical disease. To determine the presence of spinal pathology can not only a doctor but also the patient. However, in most cases, this condition does not manifest any symptoms, so it is difficult to identify.
disc protrusion of the lumbar

How to develop a protrusion in the lumbar spine

The Most frequent cause of pathology is degenerative-dystrophic changes in the spine. When blood disorder and a lack of nutrients the cartilage gets less than required for normal functioning of the component. Against this background, the intervertebral disc starts to crack and gradually destroyed.

Protrusion begins to form when ¾ around damaged parts of the intervertebral disc. At this time, the fibrous ring, which consists of more durable connective tissue and is located on the periphery, yet not destroyed.

Because the lumbar region when walking large depreciation burden, even the slightest damage to the vertebrae and cartilage leading to protrusion.

The Doctors under the disease understand the prolapse of the intervertebral disc is not more than 5 mm beyond the functional segment. If the protrusion exceeds 5 mm then the diagnosis of herniated discs (loss of the contents of the intervertebral disc with rupture of the fibrous ring).

Very often to become herniated disc protrusion levels L3-S1, as these segments of the lumbar spine bear the maximum stress when walking and lifting weights. Localization of protrusion in the lumbar vertebrae always threat the emergence of acute pain (lumbago) and impaired contraction of the muscles of the lower limbs.

For what reason gets the disc at the L1-S1

MRI shows protrusion of disk l4-l5

Computed tomography of the lumbar spine

Not only degenerative disease (impaired blood supply and trophism) of the spine leads to bulging of the intervertebral discs.

There are other reasons:

  • poor posture
  • poor development of the muscle corset back and abdominal muscles;
  • Infectious disease
  • abnormal development of the vertebrae;
  • metabolic disorder
  • overexertion
  • Hereditary hypoplasia of the cartilage.

Types of loss of lumbar discs

with the formation of the clinical symptoms of the disease influenced the type of protrusion:

  • Circular disk appears around the entire circumference of the segment is almost uniform. This pathology is often observed in the segment of L5-S1;
  • Dorsal – loss in the direction of the spinal canal. It often leads to compression of the right nerve roots in the spinal cord, localized at the level of L4-L5 lumbar spine;
  • Diffuse – irregular bulging disc, observed at several levels of the spinal column;
  • Lateral – lateral position of the protrusions. Occurs in 20% of cases, is quickly revealed, as virtually always accompanied by severe pain.

Circular protrusion L5-S1 is the most dangerous pathology. If it is often pinched sciatic nerve, which passes into the gluteal region. The designation of "L5-S1" determines the localization of the diverticulum at the level between lumbar vertebra 5 and sacral 1 vertebrae.

The same as disc protrusion L4-L5 will indicate that there is a protrusion between the 4 and 5 lumbar vertebrae.

In rare cases (around 4-5%) was observed prolapse of the intervertebral disc L2-L3.

the development of Symptoms and complications protrusion

disc protrusion l5 s1
Classic disc protrusion L5-S1 accompanied by sharp pain syndromes in the lower extremities, lower back and gluteal muscles. They indicate that the dorsal protrusion in the L5-S1 nerve roots affects.

Other signs of herniated discs in the lumbar spine:

  • the Occurrence or increased pain during physical exertion;
  • Turns pain from the buttocks to the thigh or lower leg on thigh;
  • the Presence of cramps in the calf muscles;
  • Loss of mobility and elasticity of the muscles;
  • impair the functionality of the bladder (frequent urination).

The Dorsal (back) part of the vertebral column in the lumbar region is very prone to lesions, as you'll be under her ponytail. A cluster of nerve trunks, responsible for the innervation of the lowerextremities and pelvis.

If the dorsal protrusion of intervertebral disc accompanied by a compression of the "horse's tail", there is loss of sensation of the lower extremities. When there are "bumps" in the field of hip and thigh.

Neurologists often with protrusion of the lumbosacral spine revealed symptom Lasegue. It is characterized by impaired sensation of the knee reflexes and weak innervation of the Achilles tendon (located on the back side of the heel).

The Protrusion of the intervertebral discs in the lumbar spine accompanied by pain, which "give" in the lower limbs and the gluteal region due to compression of the sciatic nerve.

complications of Sacro-lumbar protrusion

strength and intensity of complications comparable to those that appear with a hernia or compression fracture of the vertebrae:

  • Backache (lumbago) is pain in the lower back, in which a person is unable to straighten his back. It is most often observed in posterior (dorsal) the location of the diverticulum. Even the loss of 3 mm of the disc in the segment of L5-S1 can lead to backache;
  • Weakness of the gluteal muscles, fatigue in the lower extremities is observed at protrusion at the level L4-L5. It may appear paresthesia (loss of sensation) of the skin of the lower limbs
  • Diffuse protrusion of the lumbosacral spine in the segments from L3 to S1 leads to involuntary uncontrolled urination
  • Rear and lateral protrusion of the L1-L5 in the initial stages rarely lead to complications, but the irritation of the nerve roots causes severe pain;
  • From the neurological disorders in pathology can note the symptom Lasegue, which is characterized by the absence of the knee reflex and the contractility of the Achilles tendon when struck with a rubber hammer on the skin over the projection of the nerve trunks.

Treatment of protrusions of lumbar vertebra

Drug treatment of protrusion of the lumbar spine is a conservative method and includes a list of procedures which are performed mainly to eliminate the symptoms of the disease, relieve swelling and restore functionality of the spinal column.

Of the most common conservative methods of treatment can be applied:

  • Manual therapy
  • Massage
  • exercise therapy
  • Stretching the vertebral column.

These procedures are performed in the initial stages of a slipped disc. If the protrusion is running but is not manifested by severe pain, it is advisable to undergo acupuncture, which will help to improve the blood flow and thus increase the restoration of intervertebral disc.

With a slight severity of disease, strengthen the condition of damaged segments of the spine will also help physiotherapy. Of course, to cure the disease using therapeutic exercise impossible, but it will help prevent pain and other complications of protrusion of the lumbar spine (dislocation of vertebra, compression syndrome).

If therapeutic exercises combined with physiotherapy, eliminates puffiness. However, doctors in this pathology always prescribe decongestant medicines to prevent compression of the nerve roots.

Specialists trauma rehabilitation centers offer to treat prolapse of the intervertebral disc without rupture of the fibrous ring of the special exercises. They strengthen the muscles of the back, which prevents the progression of disease, destruction of vertebrae and cartilage.

Physiotherapy is a necessary and important step in the treatment of disease, as the formation of cracks in the intervertebral cartilage and vertebrae damage in most situations is a sign of an elementary violation "of the rules of operation of the musculoskeletal system".

Thus, a protrusion in the Sacro-lumbar is easier to prevent than to treat. To do this, you should not forget about the sport and the basic rules of lifting heavy loads.