Pathologies in the structure of the spine of any genesis are a serious problem. They can cause the development of irreversible complications for human health. Antelisthesis of L5 vertebra is no exception, since untimely intervention during the course of the disease can have fatal consequences, even death.
Description of the disease
Pathology consists in changing the location of the vertebra, which is advanced in relation to the rest. The result of this shift is strong nerve clamps and pain, which is especially noticeable during intense physical exertion.
The greatest danger in this case is the lumbar localization of the disease, namely in the vertebrae L4 and L5, located directly at the sacrum. In an upright position, the lumbar spine undergoes the greatest load compared to the rest. So, let's figure out what it is - an L5 vertebral antibody.
Features of the disease
This pathology of the lumbar in most cases occurs in the elderly and women. Its development occurs against the background of existing hyperlordosis, in which the natural bend of the spine protrudes strongly forward. The detection of the disease is carried out by a specialist during examination, while osteochondrosis often becomes a pathology concomitant with antelisthesis. The latter is a very common disease that affects the lumbar and cervical regions and in one form or another is found in almost every person. Numerous studies have shown that placing the vertebra downward increases the risk of bias. L5 vertebra can shift no more than 6 mm, due to its fixation to the wings of the ilium and the first sacral vertebra by ligaments.
Quite often, this ailment is mistaken for spondylolisthesis. However, these are completely different diseases. Antelisthesis of L5 vertebra involves the displacement of only the vertebral body. In the case of spondylolisthesis, not only the body undergoes displacement, but also the arches, that is, the entire structure of the vertebra moves from its place. Such a pathology is typically localized in parts of the spine, which are highly mobile due to the presence of a developed ligament apparatus.
Reasons and types
In most cases, a post-traumatic complication leads to the development of grade 1 l5 antelisthesis in the lumbar and cervical spine. Another prerequisite for its appearance is weight lifting, too sharp movement not only by the cervical, but also by any other part of the spine, as well as static pressure on the dorsal. In addition, oncological neoplasms and other degenerative pathologies can cause pathology. But a person who is distinguished by good health may encounter this disease due to some conditions, for example:
- Congenital underdevelopment of the ligamentous structure.
- Inflammatory processes in the spine, resulting in swelling and expansion of the joint capsule.
- Muscle spasm, the result of which is the displacement of the vertebrae.
The reasons why vertebral l5 antelisthesis develops play a decisive role in determining the form of pathology:
- Congenital. It manifests itself both in childhood and in adulthood.
- Traumatic, accompanied by relevant factors. In the isthmic type, trauma was inflicted in childhood or in adolescence, which led to an abnormal proliferation of connective tissue.
- Degenerative Antelisthesis Most often, the lumbar or cervical spine is affected in the elderly. It develops as a result of age-related changes in the body during aging. Most common among women.
- Pathological. It occurs against the background of cancer, and it does not matter if it is benign or malignant. Infectious diseases also relate to the causes of the development of this type of anelisthesis.
- Iatrogenic. It arises as a complication after undergoing surgery on the spine.
Symptoms
What signs of the disease will manifest themselves, and with what intensity, directly depends on the degree of protrusion of the vertebra. To determine this factor, a special classification was developed:
- Antelisthesis of l5 vertebra of the 1st degree - displacement in relation to the vertebral axis by no more than 24%.
- The second degree is an offset of 25 to 49%.
- The third degree is characterized by a shift from 50 to 74%.
- A fourth degree means an offset of more than 75%.
The first two degrees occur with minimal manifestation of symptoms. As a rule, they are accompanied by discomfort, pain with a change in body position or intense physical exertion. With the third and fourth degrees of vertebral body L5 vertebral body antelisthesis, the symptoms manifest themselves much more strongly, they are more pronounced, which is associated with a strong compression of the nerves, which disrupts the conductivity of the pulses. In the lumbar spine are the nerves that provide the innervation of the lower extremities, and they suffer in the first place. There is paralysis and paresis of the legs, loss of sensation, gradual muscle atrophy. The organs of the small pelvis and gastrointestinal tract undergo pathological changes, as there is a failure in the urethra and defecation system. The pain syndrome acquires intensity and sharpness, giving back to the legs.
Conservative treatment
At the first manifestations of l5 vertebral antelisthesis, conservative therapy is performed. In more advanced cases, the only treatment is surgery. Conservative methods of therapy involve taking anti-inflammatory and analgesic drugs.
The patient must strictly observe bed rest and wear special bandages and corsets, which will help to fix the back in the right position in order to avoid further displacement of the vertebrae.
Physiotherapy
As for physiotherapy, electrophoresis with novocaine is most often prescribed. In addition, special compresses and various ointments for external use are used. After the inflammation is removed, individually selected therapeutic exercises can be prescribed, the purpose of which is to strengthen the ligaments and muscles. In order to maximize the effect obtained from therapy, in some cases, blockades are carried out using anesthetics and anti-inflammatory drugs of local action. To restore and strengthen damaged vertebral cartilage, chondroprotectors are used. The duration of their intake should not exceed several months.
Surgical intervention
In the third and fourth degrees of development of L5 vertebral body antelisthesis, as mentioned above, conservative therapy does not produce results. The only way out is surgery. If the displacement is close to the third degree, but has not yet reached it, reduction can be appointed, however, only a highly qualified specialist should conduct it .
The pathology can be completely eliminated only if it was not started before critical changes in the spine. The operation to eliminate the antelisthesis is called spinal fusion. Its essence is to install a special metal structure, which allows you to fix the displaced spine in the correct position.
Types of fusion
Two types of fusion are distinguished. In the first embodiment, the structure is installed in the sacral region using a bracket. The second method involves the installation of metal on the rear surface. As after any surgery, spinal fusion implies compliance with the rehabilitation period. Bed rest should be observed up to two months after surgery. After this, a gradual load on the back is given. During the year after the operation, it is necessary to wear a corset, which will remove the load from the spine. Therapeutic gymnastics is also an integral part of the postoperative period. Exercises are selected individually, depending on the severity of the disease and the patient's condition after surgery.
Conclusion
Antelisthesis l5 s1 is a very serious and dangerous disease that must be treated as soon as possible. You can not start pathology, since it is better to do with conservative methods of treatment without resorting to surgery. The neglected form of the disease is treated only by surgery, however, even a correctly performed operation does not guarantee a complete cure.