The sacralization of the L5 vertebra is what? Signs, Species
Sacralization of the L5 vertebra is a congenital pathology characterized by complete or partial fusion of the last lumbar vertebra with the sacrum. Of course, people who have encountered a similar problem are looking for any additional information.
What is pathology? What are the reasons for its development? What symptoms should I pay attention to? Is it possible complications? What therapies can the doctor suggest? Many people are interested in answering these questions.
Anatomical features of
Normally, between the fifth lumbar( L5) and the first sacral( S1) vertebrae, the strongest and most stable intervertebral disc is located. It performs a number of important functions:
- reduces the impact on the spine during walking and movements( plays the role of shock absorber);
- supports the necessary dimensions of the intervertebral area, because here from the spinal cord are the important nerve fibers innervating the lower limbs and pelvic organs;
- prevents the infringement of the nerve
What is the sacralization of the L5 vertebra?
Sacralization is a congenital malformation of the development, which is accompanied by the fusion of the last vertebra of the lumbar region and the first sacral vertebra. With a similar pathology, the intervertebral disc is either reduced or completely absent.
According to statistics, this disease in one form or another is found in 7% of women and 15% of men( we are talking about patients who for one reason or another underwent X-rays of the spine).Most often the disease proceeds asymptomatically - with complications, no more than 2% of patients with this diagnosis.
Are the causes of the development of the disease known?
Unfortunately, for today the reasons for the appearance of such a pathology are unknown. This is a congenital anomaly and many scientists suggest that this disease is the result of incorrect bookmarking of ossification points during embryonic development. It is believed that sacralization develops when too many ossification points occur.
Types of intergrowth
It is worth noting that sacralization can take many forms. To begin with it is necessary to understand the type of adhesion.
- Partial one- or two-sided sacralisation of the L5 vertebra is a pathology in which the vertebrae fuse between the cell with the transverse processes, which sometimes increase to such an extent that they come into contact with the ilium. In this case, mobility in the lumbar region is maintained, although its degree is reduced.
- Complete bilateral sacralisation of the l5 vertebra is characterized by complete fusion of vertebral bodies and transverse processes that also merge with the crest of the ilium. On the radiographic picture, the vertebrae look like one single structure, the intervertebral disc is absent. The spine in this area completely loses mobility.
The true and false sacredization of
The true sacralization is said in case the patient has an innate fusion of at least one transverse process with the iliac bone. The same diagnosis is made when the last lumbar vertebra at least one side merges with the sacrum( for example, the right or left sideways sacralisation of the L5 vertebra.)
It should be noted that there are many pathologies that are accompanied by approximately the same symptoms, in such cases it is a falseThe list of such anomalies includes:
- too deep position of the vertebra L5( it literally plunges into the sacral department)
- Bekhterev's disease( pathological changes of the spine, as a rule, begin andenno in the lumbosacral);.
- appearance of marginal osteophytes on the background of progressing spondylosis
splicing process splicing occurs gradually vertebrae are three main stages Today
- Articular form of sacredization of .Transverse processes all the time touch the iliac bone, gradually making in its surface a kind of fossa. Thus, an abnormal joint is formed. At the same time, practically one hundred percent mobility of the spine remains, although periodically the patients experience pain.
- Cartilage sacredisation of .Between the transverse processes, the iliac bone and the vertebral bodies, synchondrosis is formed - an elastic and stable cartilaginous joint. Mobility in the lumbar region gradually decreases.
- Bone fusion .Between the bodies of the vertebrae, the processes and the iliac bone, a stable fusion is formed - the cartilaginous synchondrosis tissues are replaced by bone.
Signs of sacralization of L5 vertebra of
Despite the fact that quite often the ailment is asymptomatic, in some cases there is a very vivid clinical picture. Incidentally, incomplete sacralization of the L5 vertebra, as a rule, is accompanied by more pronounced symptoms.
With full intergrowth of the vertebrae, disorders occur in adulthood.
- Perhaps the main sign is back pain, which often gives to the gluteal region, hips and lower limbs. Soreness increases with physical exertion, slopes, jumps. But in the prone position, patients feel more comfortable.
- Infringement of nerves leads to loss of sensitivity of the skin in the zone of the waist and hips.
- Palpation of the spinal column is also sometimes accompanied by pain.
- Movement of the spine is limited, it is difficult for a person to lean or make a circular motion with a pelvis.
The main method of diagnosis in this case is the X-ray study. In the picture, the doctor can see that the gap between the last lumbar and the first sacral vertebra is significantly reduced, indicating a reduction and absence of the intervertebral disc. During the study, a specialist can detect an increase in transverse processes, as well as a partial connection of vertebral bodies.
What are the consequences of the ailment?
As already mentioned, the transition disc between the marginal vertebrae of the lumbar and sacral section should normally be strong and elastic, as it provides amortization during movement.
If the intervertebral disc is atrophied or completely absent, additional areas of the spine are subjected to additional stresses. This leads to gradual dystrophy. The sacralization of the L5 vertebra often results in spondyloarthrosis and osteochondrosis.
To the list of complications it is possible to carry a compression of nervous beams of the lumbosacral department which is accompanied by the expressed painful syndrome( so-called "horse tail syndrome").Also, the presence of such an anatomical abnormality increases the risk of developing scoliosis and some other pathologies of the spinal column.
What is included in the treatment regimen?
Complete or partial sacralization of the L5 vertebra does not lend itself to medical treatment. Nevertheless, with the help of conservative therapy it is possible to relieve soreness and discomfort, improve the patient's quality of life.
- Taking anti-inflammatory medications and analgesics helps to stop the attack of pain. Both injection solutions and tablet formulations can be used.
- Doctors recommend wearing special fixing corsets on the sacro-lumbar region. This helps to prevent the development of complications, reduces the risk of injury.
- An integral part of the treatment is special gymnastics. The complex of exercises should be selected by an experienced physiotherapist. Regular physical exercises help to strengthen the muscular corset and relieve the load from the spine.
- Effective is also a massage that helps to relieve spasm, strengthen muscles, improve blood circulation.
- Such procedures as electrophoresis with novocaine and paraffin applications, help to remove soreness, warm up muscles, eliminate spasms and discomfort.
- Acupuncture sessions can also cope with unpleasant sensations.
Features of surgical intervention
Unfortunately, the sacralization of the L5 vertebra does not always yield to conservative therapy. The doctor decides to perform the surgery if there are the following indications:
- severe pain that spreads to the back and limbs;
- compression of the nerve roots, which leads to a violation of normal urination and defecation;
- loss of sensitivity in the limbs, which again is associated with compression or trauma to the nerves.
There are several methods of surgical correction:
- excision of the tips of the transverse processes of the vertebrae;
- surgical separation of borderline vertebrae;
- placement between the vertebral bodies of a special transplant, which replaces the missing intervertebral disc and performs its functions.
In most cases, operations take place without any complications. Naturally, further followed by a relatively long period of rehabilitation, which includes some methods of conservative therapy.