Pain in the back is familiar to many. They can be associated not only with intervertebral hernia or osteochondrosis, pain often occurs when vertebral displacement occurs. In medicine, traumatologists face this problem every day. The prevalence of pathology (a few decades ago it was extremely rarely diagnosed) is caused by the appearance of degenerative phenomena in the spine, even in young people. Pathology may not occur for a long time, but its consequences pose a health hazard, since pinching of the nerves can cause the development of many health problems.
Description and description of the problem
Displacement of the vertebrae (spondylolisthesis) is a disease of the spinal column, in which the vertebra can move forward, backward or turn around relative to other vertebrae. Such a pathology often leads to curvature of the spine, as well as squeezing of nerves and spinal cord. This provokes the development of disorders of the internal organs and central nervous system. With spodilolisthesis, there is not only a strong pain syndrome, but also a limitation of mobility.
In traumatology, it is customary to distinguish several types of disease depending on the side of the displacement of the upper vertebra:
- Anthespondylolisthesis, in which the vertebral body shifts forward.
- Retrospondylolisthesis when the vertebra slides back.
- Laterospondylolisthesis, when the vertebra shifts to the left or right.
Due to the anatomical structure of the spinal column, not all of its departments are affected to this disease to the same degree. In the cervical spine , the middle cervical vertebra usually shifts, pathology is infrequent in the thoracic spine , usually the disease affects the lumbar spine . This is due to physical activity, improper posture. Also, the vertebrae often move in the coccygeal region as a result of injuries.
Forms of pathology
There are several forms of this pathology:
- The congenital form is characterized by intrauterine developmental disorders.
- The traumatic form develops as a result of an injury to the spinal column when a leg, joint, or arch fracture occurs, or due to regular loads on the spine.
- The isthmic form is diagnosed in athletes, it is caused by a change in the surface of the vertebra between the joints.
- Degenerative (false) form in which there is a violation of the articular vertebrae due to the development of osteochondrosis or arthritis. Pathology usually develops in old age.
- A pathological form in which the vertebrae are displaced due to a tumor, deformation of bone tissue.
- The post-surgical form is formed after surgical manipulations on the spinal column.
Causes of the disease
The main causes of vertebral displacement are described above. In most cases, the displacement occurs due to the development of a defect in one vertebra, which causes a fracture of its legs, which grows together with time and forms a scar that prevents the spine from taking its previous position.
Sometimes the disease provokes injury to the spine in childhood, but its signs appear after many years. In this case, a leg fracture does not heal to the end. Also, displacement occurs after surgical manipulations on the back, with pathology of the joint-ligamentous apparatus, or as a result of age-related changes in the body.
The vertebral body may shift for the following reasons:
- Congenital malformation of the articular ligamentous apparatus or spinal column.
- The development of arthrosis or osteochondrosis.
- Damage to the back as a result of falling on it.
- Constant physical activity.
- Surgery on the spine or back.
- Pathology of the surface of the vertebrae between the joints.
- The presence of benign or malignant neoplasms.
Symptoms and signs of pathology
Displacement of the vertebrae manifests various symptoms depending on the location of the pathological process, the degree of development of the pathology. Regardless of the spinal column, spondylolisthesis leads to irritation or pinching of the nerve roots, which provokes the development of edema, inflammation and pain in the back. Signs of the disease do not appear all at once. They may not be very pronounced, but sometimes severe severe pain in the spinal column is observed.
The displacement of the vertebrae of the neck is accompanied by a headache, restriction of head movement, and a crunch in the joints. A person has numbness of the tongue, throat and upper limbs, their innervation is disturbed, there is a fever, VVD, tinnitus, violation of blood pressure. If the cervical vertebra is pinched, neurosis, insomnia, hypertension, ear pain, neuritis or neuralgia develop, strabismus, adenoiditis, and ENT diseases are possible.
With pathology in the thoracic spine, pain appears between the shoulder blades, muscle spasm, pain in the chest area that mimic heart pathology, and the inability to take a deep breath. In severe cases, the development of asthma, disturbances in the activity of the cardiac system, circulatory disorders, the appearance of pathologies of the digestive tract, kidneys and liver, rheumatism and pain in the intestine are possible.
In the lumbar region, vertebral displacement has consequences in the form of lumbago and lumbalgia, pinching and inflammation of the sciatic nerve, and the development of radiculitis. A person has limited movement, a violation of the sensitivity of the lower extremities, muscle spasm. In some cases, acidosis, defecation disorder, menstrual irregularities in women, and development of impotence in men are observed. Sometimes the displacement of the vertebrae in children leads to a pinch of the sciatic nerve and the development of seizures. With pathology in the coccyx, hemorrhoids may develop.
The above violations do not appear immediately, they can occur even after a few years.
Stages of the development of the disease
There are several stages of the disease:
- The first stage is caused by a slight displacement of the vertebra, the absence of signs of the disease. Over time, there is pinching and deformation of the nerves, they lose their functions.
- The second stage, in which the vertebra slides halfway, slight pain begins to appear, which intensifies when the movements are made.
- The third stage, in which the spine begins to sag due to displacement of the vertebra by more than half. The pain becomes severe, movements are limited.
- The fourth degree is characterized by complete bias. In this case, irreversible changes occur in the body, including curvature of the gait and paralysis of the limbs.
Diagnostic measures
At an early stage of the development of the disease, it is difficult to diagnose, since it does not show symptoms. Usually, pathology is detected during a routine examination of other organs.
Displacement of the vertebrae is diagnosed by a traumatologist or neurologist after studying the medical history, interviewing and examining the patient, as well as studying the results of the tests. When conducting a survey, the doctor finds out the nature of the pain, its frequency and localization. On examination, changes in the spinal column and associated disorders are revealed. Then the traumatologist palpates the pathological area, checks reflexes and muscle tone, as well as skin sensitivity.
To make an accurate diagnosis, the patient is sent to such examinations as X-ray in several projections, MRI and CT to exclude neoplasms and intervertebral hernias. Such diagnostic techniques make it possible to identify the type of vertebral displacement, its localization and the presence of secondary diseases. As additional methods, electroneuromyography and laboratory tests are used. Also, when making a diagnosis, the doctor takes into account the physical condition of the patient, his motor skills, and bending of the spine. After studying the results of the examination, the doctor makes an accurate diagnosis and develops treatment tactics.
Pathology treatment
Vertebral displacement treatment involves a comprehensive and individual. It must necessarily include manual therapy, which makes it possible to eliminate the cause of the development of pathology, to make reposition of the vertebrae. In each case, the doctor prescribes an individual treatment regimen, which will depend on the stage of development of the disease. The main focus of therapy is the elimination of the causes of the disease, relief of pain and complications of the pathology.
Medication is aimed at eliminating pain with painkillers, the inflammatory process with anti-inflammatory drugs or NSAIDs. Chondoprotectors are also prescribed for treatment with the goal of restoring cartilage, muscle relaxants and massage with displacement of the vertebrae to relax muscle tissue and restore its tone. Sometimes, forced traction of the spinal column can be used to return the vertebra to its original place.
Manual therapy
Almost always, the doctor prescribes exercise therapy and manual therapy, which contribute to the full return to the place of the displaced vertebra. Acupuncture is also recommended to eliminate pain and normalize muscle tone, hirudotherapy in order to improve blood properties and normalize blood circulation.
Diseases and thermal procedures are also used as therapy, in particular, heating with salt warmers or infrared rays. Such techniques make it possible to deeply warm tissues, eliminate pain, normalize blood circulation and metabolic processes in the body. Such procedures can be combined with cryotherapy for deeper tissue warming. In this case, the skin is exposed to extreme cold, which causes spamming of blood vessels, and then their expansion and increased blood supply. This procedure has an analgesic effect.
Often, the doctor prescribes laser therapy to reduce inflammation and accelerate the restoration of cartilage and nerve tissue. This procedure acts as a powerful biostimulator, which makes it possible to greatly accelerate the healing process in a natural way. To eliminate the edema of the nerve roots, normalize blood flow, increase the adaptive capacity of the body, ultrasound therapy is used with the help of relaxing currents. Also, the doctor may prescribe other procedures.
Surgical intervention
In advanced and severe cases, they resort to surgical intervention. Also, this method is used when conservative treatment was ineffective. During the operation, two adjacent vertebrae are connected using special plates, while the deformed sections of the vertebrae are removed. This method makes it possible to fix the spine and limit its mobility. After a while, the doctor will prescribe exercises for the displacement of the vertebrae. It is important to undergo rehabilitation twice a year to eliminate the risk of re-development of the disease.
Forecast and Prevention
The prognosis of the disease is generally favorable, the disease responds well to therapy. But in some cases, pathology leads to a limitation of human activity, and in severe cases, health complications may appear.
The danger of the disease lies in the fact that for a long period of time it does not show symptoms, so people go to the doctor when the signs of the disease become pronounced. Often, complications of this pathology are disorders of the nervous system. Sliding a particular vertebra leads to specific health problems.
In the presence of pathologies of the spine to prevent displacement of the vertebrae in the future, preventive measures must be taken. In this case, doctors recommend limiting the upright position of the body, especially when performing physical exertion. It is necessary for some time to abandon the power load, wear a corset to maintain posture, use anti-inflammatory drugs.
Doctors recommend that every person periodically take a complex of vitamins and minerals, especially those that contain calcium. This is done to strengthen bone and muscle tissue, as well as ligaments. To maintain the musculoskeletal system, it is recommended to exercise, gymnastic exercises, exercise. When lifting weights, you can not make sharp movements up, it is recommended to sit down, and then lift the load.
Displacement of the vertebrae today is found in many people, especially those who are engaged in physical activity. This pathology can be cured, the main thing is to consult a doctor in time to establish a diagnosis.