Lumbarization of the S1 vertebra is a rare abnormality that occurs as a result of abnormalities in the development of the spine. Pathology is diagnosed only in 2% of people treating lower back pain. Often, this deviation from the norm does not manifest itself for many years and can only be detected during an annual medical examination. It is important to conduct timely treatment, which will subsequently avoid serious health complications.
General concept of anomaly
In a healthy person, the sacral spine is a single fused bone in the lower part of the spine. When driving, the entire load falls on it. With the normal structure of the lumbar, all vertebrae are interconnected by strong formations, which ensures their immobility.
Lumbarization of the S1 vertebra is an abnormal change in the sacrum, characterized by the underdevelopment of the initial sacral segment (S1). As a result, this vertebra does not connect with the rest of the bone structures and forms a separate sixth vertebra (L6) in the lumbar region.
According to the anatomical structure, it does not differ from a healthy bone segment. The only difference is that it is not fixed in a single whole with others, therefore it has a certain range of motion. Even if during the diagnosis it was established that he almost merged with the sacral department, the diagnosis still remains unchanged.
When lifting weights, a shift of the formed part of the spine occurs as a result of improper load distribution. This is characterized by soreness in the lumbar region. If untreated, the anomaly leads to the development of serious complications.
Classification
In medicine, there are several classifications of this spinal anomaly.
The following types of pathology are distinguished depending on the degree of discharge of the first vertebra of the sacrum:
- Complete lumbarization of the S1 vertebra. In this case, 6 separate vertebrae of the lumbar region are clearly distinguished in the X-ray. A distinctive feature of this type of anomaly is that the initial bone segment (S1) is not associated with other vertebrae, but is a separate element of the lower back.
- Partial lumbarization of the S1 vertebra. This kind of abnormal change maintains a connection with the sacrum and partly with the lumbar, despite the appearance of tears. The development of pathology is characterized by partial immobilization of the lower back, accompanied by soreness.
Depending on the localization of abnormal changes, the following varieties exist:
- left-side or right-sided lumbarization of the S1 vertebra;
- bilateral separation of the S1 vertebra.
Causes
It is still not possible to establish the exact cause of the anomaly. But experts insist that the main provoking factor are violations of the intrauterine development of the child during the 3rd trimester of pregnancy. Since it is at this time that the skeleton is formed.
Contributing reasons:
- untimely treatment of infectious pathologies of a woman;
- smoking and drinking during the gestation period;
- pregnancy over the age of 30;
- taking medications without consulting a gynecologist;
- genetic predisposition.
In 60% of adolescents suffering from scoliosis, the cause of the development of pathology is a violation of the development of the spine, one of which is lumbarization. Therefore, it is so important when planning pregnancy to normalize nutrition, abandon bad habits and protect yourself from infectious diseases at least six months before the proposed conception.
Clinical symptoms
Signs of abnormal changes in the spine may not be felt for a long time. Most often, they appear after 40 years, when the natural processes of aging begin in the body.
Clinical signs of lumbarization of the S1 vertebra may vary depending on the form of the pathological process.
| Lumbarization form | Characteristic symptoms |
| Lumbar | - constant aching pain along the entire spine;
- partial loss of sensation in the lower back and upper legs;
- limited mobility in the sacro-lumbar segment;
- pronounced bulge of the spine forward;
- acute pain on palpation of the lower back
|
| Sciatic | - pain radiating to the buttocks, feet, hips and lower limbs;
- increased pain with prolonged walking or standing, which takes place in a prone position;
- the inability to raise the leg in a supine position;
- acute pain in the lumbar region when descending the stairs, and the rise of such uncomfortable sensations does not cause
|
The presence of an anomaly can be recognized by the sharp pain that occurred when jumping with bent knees and trying to land on your heels. But this diagnostic method needs confirmatory studies. Therefore, an accurate diagnosis can only be made by a doctor.
What is dangerous spinal anomaly?
The sooner a deviation from the norm is detected, the less likely it is to develop serious complications. The absence of unpleasant symptoms is not a reason for refusing treatment for lumbarization of the S1 vertebra.
Ignoring the problem can lead to the development of the following pathologies:
- osteochondrosis;
- scoliosis;
- kyphosis;
- spondylosis.
In children, a mandatory physical examination helps to identify a pathological change upon admission to a preschool and school institution. If the appropriate treatment is not carried out at this age, then this will provoke the progression of other deviations against the background of underdevelopment of the sacral section.
These include:
- displacement of the sacrum back when lifting weights;
- deterioration of blood circulation in the tissues adjacent to the abnormal segment;
- radicular syndrome;
- violation of the axis of the spine.
All these pathological changes negatively affect the posture of a person, the tone of the abdominal muscle tissue and the work of the pelvic organs.
Diagnostics
The main diagnostic method for lumbarization of the S1 vertebra is x-ray, which helps to obtain comprehensive data on the presence of anomalies in the sacro-lumbar spine. The study is carried out in 2 projections.
The main criteria to detect lumbarization of the S1 vertebra on an x-ray:
- a gap in the upper sacral vertebrae;
- reduced length of the spinous process that closes the lumbar vertebra;
- the presence of additional shadow in the region of the fifth vertebra of the lumbar;
- vertebra height at L5 level is less than normal.
If after the x-ray the doctor has doubts, then an additional MRI and CT scan is prescribed. And also requires a consultation of a neurologist, which will exclude radicular syndrome, radiculitis, lumbar ischialgia.
The main methods of treatment
Mandatory therapy is necessary if a person has unpleasant sensations in the lumbosacral region, which limit mobility and negatively affect the quality of life. And also treatment is carried out if abnormal changes in the spine provoke the development of complications.
Taking medication is prescribed only to eliminate clinical symptoms.
The main types of drugs:
- chondroprotectors ("Don", "Arthra");
- microcirculation correctors (Actovegin, Trental);
- NSAIDs (Diclofenac, Ketoprofen);
- muscle relaxants ("Tizanidine", "Midokalm").
The course of therapy and the dosage of drugs are prescribed by the doctor, depending on the type of established anomaly and the severity of symptoms during the exacerbation period.
In the future, the treatment regimen includes the following procedures:
- wearing a corset;
- acupuncture;
- physiotherapy; electrophoresis;
- massage;
- paraffin baths;
- ultrasound therapy.
Sanatorium and preventive treatment are also recommended.
Features of physiotherapy exercises with lumbarization of the S1 vertebra
Physical therapy is also one of the treatment methods, but possible exercises are preliminarily agreed with a rehabilitologist.
Therapeutic gymnastics with lumbarization of the S1 vertebra is carried out in a horizontal position with bent legs, but the feet should remain on the floor. Vertical exercises are not recommended, since any inclinations or turns can provoke the development of an unstable form of pathology.
When diagnosing a disease in children, physiotherapy exercises are supplemented by corrective exercises that help correct spinal curvature in the lumbar region.
Surgery
Surgical intervention is prescribed extremely rarely if the patient does not have acute pain even after taking painkillers. Indication for surgery is also impaired stability of the spine.
The purpose of this is the artificial fusion of bone segments. For this, the vertebrae S1 and S2 are fixed between themselves by an iron plate, and with the help of a special corset, the lumbosacral region is immobilized.
If artificial splicing is not possible, the vertebra S1 is fixed directly to the sacrum, and a special disk is installed between the bone segments S1 and S2.
Useful tips on how to live with full and incomplete lumbarization of the S1 vertebra
Patients with these pathological changes in the structure of the spine are recommended to follow certain rules throughout their lives. These restrictions help reduce the load on the damaged segment and eliminate the development of complications:
- You should sleep on a hard mattress.
- It is necessary to exclude the lifting of heavy objects both in everyday life and when choosing a professional activity.
- If necessary, lift the object from the floor should first sit down, and only then pick it up. But it’s best to ask loved ones for help.
- Physical activity and sports are limited.
Adhering to these recommendations, a person with this abnormal change in the spine will remain able to work for many years.
Reviews
The lumbarization of the S1 vertebra, according to doctors, is not a danger to human life. But pathology requires timely treatment, which eliminates the likelihood of secondary changes. The prognosis of specialists in both conservative therapy and surgery is favorable.
But it is worthwhile to understand that throughout life, a person must observe the restrictions associated with physical activity. Only a careful attitude to your health will help maintain a full-fledged ability to move around and lead a familiar lifestyle.