In the case of lumbar spondylolisthesis, symptoms and treatment of the disease will be further discussed, a person's mobility is limited, a person's ability to adopt a habitual lifestyle. Nearly half of patients complain of pain in this part of the back. According to Poll Options Are results, lumbar necrosis is second after respiratory diseases.
If until recently age-related degenerative processes were considered the main cause of the pathology, now many factors that cause the disease have been clarified. Before starting therapy, it is important to have a clear understanding of what is lumbar spondylolisthesis.
Disease is a pathological change in the disc, accompanied by atrophy of the ligament, destroying the trunks of the vertebrae themselves. The lumbar spine is the place to suffer the most, as it incurs a great load when lifting the weights in a sitting position.
Signs of lumbar spine degeneration are increasingly evident in young people over the age of 30. Can not start the disease, because complications turn into disability, paralysis of the lower extremities.
Main symptoms of lumbar necrosis
Lumbar fibroids are a deformation pathology, in most cases a natural aging process. But the increased physical activity on the spine, metabolic disturbances, the abuse of toxic products and alcohol accelerated this process.
The first signs of pathology do not appear immediately, so therapy does not always start on time. With lumbar spinal necrosis, symptoms are as follows:
Pain- is usually more painful in the early and acute stages at 2-3 stages of disease development (with any sudden movement, discomfort becomes stronger and when resting atthe bed will be over);
- with osteonecrosis, a feeling of weakness appears in the legs (loss of tendon reflex in the lower extremities, clearly visible on neurological examination);
- curvature of the waist;
- violation of urination and defecation (depending on where the spinal cord was pinched).
Other symptoms of lumbar necrosis can also be identified: a feeling of numbness in the lower back, dry and flaky skin, a change in skin color (turning to blue). Increased sweating in the buttocks area. One of the signs of bone tumors in men of the lumbar spine is considered to be erectile dysfunction.
When there is necrosis of the lumbar spine, symptoms vary in severity. Some manifestations may combine into a syndrome.
| Syndrome | Features |
| Ischemic | Here, signs of lumbar necrosis appear due to damage to the blood vessels. The arteries begin to constrict (this process becomes permanent over time). This condition is characterized by pain in the muscles of the legs and thighs while walking. If the blood vessels are pinched and constricted for a long time, the nutrition of the pelvic organs is disturbed, as well as their function. In women, the pathology causes problems with the menstrual cycle, fertility, incontinence |
| Vertebrae | It is characterized by pain of varying intensity and location. It arises after a load on the lumbar spine: tilting, lifting heavy objects. If there is a herniated disc, the patient may lose sensitivity in the leg. In this case, changes in the spine occur: changes in position, sagging body, problematic gait |
| Spacer | The vertebrae become unstable, not only squeezing nerve roots, but also squeezing blood vessels. One symptom of the syndrome is pain in the pinched site of the ends. Discomfort spread down the buttocks and legs. A person has increased muscle tone, he or she is forced to change gait. In the absence of treatment for bone necrosis, the nerve roots become inflamed. This condition is accompanied by edema of the body tissues around the spine. Blood starts to stagnate, and the drunk process begins. With lens syndrome, pain is observed in other joints. In addition to these symptoms, a feeling of "goosebumps" appears in the lower back (lower back). In particularly difficult cases, patients cannot move independently anymore |
People with lumbar necrosis need a physical exam to find out the severity of the disease and determine treatment regimen.
Degree of lumbar degeneration
Lumbar fibroids develop gradually. There are such stages of pathological progression:
- First. In this case, the root canal, located inside the disc, begins to move and change. Cracks appear on the fiber ring. Nerve roots are irritated, signaled by back pain. At this stage of osteonecrosis, discomfort is still local, ie symptoms are felt only in the affected disc area. Sometimes it is low back pain but in the early stages often dull pain constantly. Discomfort in bone necrosis increases after a load is placed on the lumbar spine.
- Second. Here the loop destruction occurs. The motor capacity of the injured vertebra increases, while muscle tissue becomes strained. The distance between them gradually decreases, they can move relatively with each other. A person becomes more difficult to move because quickly gets tired, feeling discomfort in the lower back. The pain spread down the thighs, legs, and buttocks. People sweat more.
- Third. In this stage of the disease, the pain is more severe than many times, due to the broken fibrosis. In this case, the medullary nucleus leaves its place and forms a herniated mass. Patients experience acute and low back pain when nerve roots and tissues are pinched. The discomfort becomes constant and unbearable. The work of internal organs was interrupted.
- Wednesday. Deformation of the spine occurs. It is very difficult for a person to move but the pain becomes less pronounced. This does not mean that the disease no longer develops. This state is a signal that a person will soon be in a wheelchair. In addition, in the damaged disc area, bone tissue develops, aggravates the condition, muscles atrophy.
If the development of the disease is not controlled and treatment is not started on time, the vertebrae will simply deflate and restore them without a difficult and risky surgery will noteffective.
What to do in case of an exacerbation
Lumbar fibroids are a difficult disease to treat, should not move to the last stage. It quickly becomes chronic, as even the most effective treatment can only stop the development of the pathology or slow it down.
If there is severe pain in the back area and one is unable to move normally, this indicates an exacerbation of the pathological process. Most often it happens in patients who do not follow the doctor's recommendations. If the exacerbation has occurred, one should follow the following rules:
- It's a good idea to completely give up physical activity for as long as it takes to restore normal bodily function. It is better to lie in a comfortable position that doesn't cause discomfort. It is very good if the patient uses a stiff mattress, as the body in this case (particularly the lumbar region) does not sag.
- To minimize the back load, a person can use a semi-rigid corset. It will limit sudden movements.
- To reduce the severity of pain in osteonecrosis, you need to slowly bend your leg at the affected knee. This will help relieve muscle tension and reduce pinched nerve tissue.
- In difficult cases, an applicator can be used but care must be taken. The procedure is performed twice a day for 30 minutes.
- After massage gradually restores normal blood circulation and muscle tone, an anti-inflammatory ointment should be used.
The affected area could not be warmed on the first day after the onset of exacerbations. Dry heat is applied only on the second day when the pain has peaked. Otherwise, tissue edema will increase, and the patient's condition with bone necrosis will worsen.
Diagnosis
Lumbar fibroids require a serious approach and complex therapy. Patients will become more easily if they use the right drugs, perform the exercises as prescribed by the doctor. To choose a treatment regimen, patients should be seen. The following diagnostic methods stand out:
X-ray- . If the lumbar joints are affected, radiological evaluation is considered primary. Images are captured in several projections. On it you can see the lesion of the disc, the condition of the spinal canal. Each slide must be perpendicular to the previous projection.
- MRI or CT. The procedures presented help to more accurately identify which factors trigger the development of osteonecrosis, under which conditions are not only vertebrae but also soft tissues, blood vessels, nerve ends. . At the same time, the patient does not feel uncomfortable.
- External examination by palpation of the lesion and neurological examination.
Only a thorough diagnosis can determine whether a person actually develops osteonecrosis.
Treatment of lumbar necrosis
Without lumbar manipulation, complications such as bulging eyes, degenerative spondylosis, herniation, sciatica, spinal stenosis, and muscle dysfunction may occur. pelvic view. He also began to limp, paralyzed and paralyzed his legs.
Treatment of lumbar spinal necrosis poses a number of tasks. First, it is necessary to eliminate the painful inflammation of the disease. Naturally, it is necessary to stop unpleasant symptoms on your own, as well as increase the muscle contraction power of the lumbar and lower extremities.
This therapy will reduce swelling and spasm of soft tissue. The patient is assigned means and procedures designed to improve the function of organs, regulate blood circulation, restore metabolic processes in the body and also expand the range of motion. Because degenerative spondylolisthesis disease will have to be treated for a long time, you need to choose the methods that bring good results and least harm. Medicines, alternative therapy, physiotherapy, LF, and other methods are used.
Surgery
In severe cases, when the disease has advanced to an advanced stage, bone necrosis in the lumbar region requires surgical intervention. The help of a surgeon is necessary in case of complications impairing the function of organs or spinal hernia. An emergency operation is performed if there is a risk of paralysis of the lower extremities.
The most effective intervention is to remove the damaged disc. Also widely available is the microsurgical method of treating lumbar fibroids with an endoscope. This procedure causes little trauma to the patient and allows him to recover in the shortest time possible.
Physiotherapy
With lumbar necrosis, symptoms (they are treated in different ways) can be eliminated with the help of physiotherapeutic procedures. Useful:
- diadynamic line;
- electrophoresis and phonophoresis;
- magnetotherapy;
- laser treatment.
Physiotherapy procedures will bring the maximum benefit when combined with drugs.
Physical therapy exercise
Treatment of lumbar necrosis is ineffective without performing a complex exercise therapy prescribed by a doctor. All exercises are aimed at improving lower back mobility, strengthening muscle strength and increasing stability of the spine. Complexes must be performed regularly.
The doctor usually appoints the following exercises: bend the body in many different directions, standing, walking with all four legs back and forth, stretching the abdominal muscles in the supine position.
Massage
It can be done only after the exacerbation has been eliminated or during remission. Thanks to this procedure, you can not only relax the muscles that are contracting, but also help strengthen them. After bathing, massage will be more effective. It should be done by a specialist using the right techniques: stroking, massage. The procedure should not be performed if there is an open wound on the back, someone has been diagnosed with a dermatosis or has a circulation problem.
Manual therapy
Manual therapy deals with the same tasks as massage, but uses slightly different techniques. You cannot trust your spine for an amateur. An experienced specialist is required for the procedure, who will do no harm.
Medicines
In the treatment of lumbar spinal necrosis, medication cannot be dispensed. When choosing them, the general state of the body, the stage of the disease development is what matters. To combat osteonecrosis, there are the following groups of most effective drugs:
Pain reliever.
- NSAIDs - These drugs clear up the inflammation and pain that accompany it. They reduce swelling, normalize body temperature.
- Muscle relaxants - These are prescribed by a doctor and are used only when NSAIDs are unsuccessful. Muscle relaxants help reduce muscle spasm.
- Chondroprotectors- They keep the cartilage in good condition without allowing it to break down. But they only work if this class is not completely deleted.
- Anti-inflammatory steroid drug. They are indicated last in the most advanced cases.
- Multivitamins and B vitamins - Prescribed preparations help improve the function of NS.
- Antidepressant (to restore the patient's emotional background).
- Block novocaine with Hydrocortisone. They are located just inside the back, where the pain originated. Blockades are rarely performed, as they are capable of causing muscle atrophy.
- Preparations for improving blood circulation and microcirculation.
Topical - ointment - has a good effect and has few side effects. If the patient uses folk remedies for therapy, they must continue to take the medicines.
Prevention of lumbar spine necrosis
Lumbar spine u can be prevented if you adhere to simple rules of prevention:
- avoids hypothermia and infection;
- does not lift heavy objects; The
- bag is worn alternately on both shoulders;
- adhere to the correct diet and diet;
- keeps your body weight within normal limits;
- promptly treat congenital or acquired bone diseases;
- go swimming, be more active, do complex lumbar exercises every day;
- get regular checkups.
Basic self-care will help avoid the complications of lumbar necrosis, and there are many complications and it is difficult to deal with.