Pain in the back is familiar to many. They can be associated not only with intervertebral hernia or osteochondrosis, pain often occurs when the vertebrae are displaced. In medicine, traumatologists face this problem every day. The prevalence of pathology (a few decades ago it was diagnosed extremely rarely) is due to the appearance of degenerative phenomena in the spine, even in young people. Pathology may not appear for a long time, but its consequences are dangerous to he alth, since pinched nerves can cause many he alth problems.
Characteristics and description of the problem
Displacement of the vertebrae (spondylolisthesis) - a disease of the spinal column, in which the vertebrae can move forward, backward or turn around relative to other vertebrae. This pathology often leads to curvature of the spine, as well as compression of the nerves and spinal cord. This provokes the development of disorders of the internal organs and the central nervous system. With spodylolisthesisthere 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:
- Antespondylolisthesis, in which the vertebral body moves forward.
- Retrospondylolisthesis, when a vertebra slips back.
- Laterospondylolisthesis, when the vertebrae shifts to the left or right.
Due to the anatomical structure of the spinal column, not all of its departments are equally affected by this disease. In the cervical spine, the middle cervical vertebra is usually displaced, in the thoracic region the pathology is rare, usually the disease affects the lumbar region. This is due to physical activity, poor posture. Also, the vertebrae are often displaced in the coccygeal zone 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 pedicle, joint or vertebral arch fracture occurs, or due to regular stress 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.
- Pathological form, withwhich the vertebrae are displaced due to a tumor, deformation of the bone tissue.
- The post-surgical form is formed after surgical manipulations on the spinal column.
Causes of disease development
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 pedicle, which fuses over time and forms a scar that prevents the spine from taking its previous position.
Sometimes the disease provokes trauma to the spine in childhood, but its signs appear after many years. In this case, the fracture of the leg does not grow together to the end. Also, displacement occurs after surgical manipulations on the back, with pathology of the articular-ligamentous apparatus, or as a result of age-related changes in the body.
The body of a vertebra may move for the following reasons:
- Congenital malformation of the articular-ligamentous apparatus or spinal column.
- Development of arthrosis or osteochondrosis.
- Injury to the back from falling on it.
- Permanent physical activity.
- Surgery on the spine or back.
- Pathology of the surface of the vertebrae between the joints.
- Presence of benign or malignant neoplasms.
Symptoms and signs of pathology
Displacement of the vertebrae shows different symptoms depending on the location of the pathological process, the degree of development of the pathology. Regardlessof 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 there is a strong sharp pain in the spinal column.
Displacement of the vertebrae of the neck is accompanied by headache, restriction of head movement, crunching in the joints. A person has numbness of the tongue, throat and upper limbs, their innervation is disturbed, fever, VSD, tinnitus, and blood pressure disorders appear. If the cervical vertebra is pinched, neurosis, insomnia, hypertension, earache, neuritis or neuralgia develop, strabismus, adenoiditis, ENT diseases may develop.
In case of pathology in the thoracic spine, there is pain between the shoulder blades, muscle spasm, pain in the chest area, which mimic the pathology of the heart, the inability to take a deep breath. In severe cases, it is possible to develop asthma, disorders of the cardiac system, circulatory disorders, the appearance of pathologies of the digestive tract, kidneys and liver, rheumatism and pain in the intestines.
In the lumbar region, the displacement of the vertebrae has consequences in the form of lumbago and lumbalgia, pinching and inflammation of the sciatic nerve, and the development of sciatica. A person has limited movement, a violation of the sensitivity of the lower extremities, muscle spasm. In some cases, there is acidosis, defecation disorder, menstrual irregularities in women, development of impotence in men. Sometimes the displacement of the vertebrae in children leads to infringement 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 disease progression
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, pinching and deformation of the nerves is observed, they lose their functions.
- The second stage, in which the vertebrae slip halfway, slight pain begins to appear, which intensifies with movement.
- The third stage, in which the spine begins to sag due to the displacement of the vertebra by more than half. The pain becomes severe, movement is limited.
- The fourth degree is characterized by complete displacement. In this case, irreversible changes in the body occur, including the curvature of the gait and paralysis of the limbs.
Diagnostic measures
At an early stage, the disease is difficult to diagnose, as 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 history of the disease, questioning and examining the patient, as well as studying the results of the tests. When conducting a surveythe doctor finds out the nature of the pain, its frequency and localization. On examination, changes in the spinal column and related 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 referred for examinations such as radiography in several projections, MRI and CT to exclude neoplasms and intervertebral hernias. Such diagnostic methods make it possible to identify the type of vertebral displacement, its localization and the presence of secondary diseases. Electroneuromyography and laboratory tests are used as additional methods. Also, when making a diagnosis, the doctor takes into account the patient's physical condition, his motor skills, and the curves of the spine. After studying the results of the examination, the doctor makes an accurate diagnosis and develops therapy tactics.
Treatment of pathology
Displacement of the vertebrae 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 reposition 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 direction of therapy is the elimination of the cause of the development of the disease, the relief of pain and complications of the pathology.
Drug treatment is aimed at eliminating pain with the help of painkillers, the inflammatory process with the help ofanti-inflammatory drugs or NSAIDs. Also, chondoprotectors are prescribed for treatment in order to restore cartilage tissue, muscle relaxants and massage in case of displacement of the vertebrae to relax muscle tissue and restore its tone. Sometimes forced spinal traction can be used to bring the vertebra back into place.
Manual Therapy
Almost always, the doctor prescribes exercise therapy and manual therapy, which contribute to the complete return to the place of the displaced vertebra. Acupuncture is also recommended to eliminate pain and normalize muscle tone, hirudotherapy to improve blood properties and normalize blood circulation.
Used as a therapy for diseases and thermal procedures, in particular heating with s alt heaters or infrared rays. Such techniques make it possible to deeply warm the tissues, eliminate pain, normalize blood circulation and metabolic processes in the body. Such procedures can be combined with cryotherapy for deeper tissue heating. In this case, the skin is exposed to extreme cold, which causes a spam of blood vessels, and then their expansion and increased blood supply. This procedure has an analgesic effect.
Often, a doctor prescribes laser therapy to reduce inflammation and speed up the processes of restoration of cartilage and nervous tissue. This procedure acts as a powerful biostimulant, which makes it possible to greatly accelerate the healing process in a natural way. To eliminate swellingnerve roots, normalize blood flow, increase the adaptive capacity of the body, ultrasound therapy is used with the help of relaxing currents. The doctor may also prescribe other procedures.
Surgery
In advanced and severe cases, they resort to surgical intervention. It is also used when conservative treatment has failed. 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, he alth 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. The slippage of a particular vertebra leads to specific he alth problems.
In the presence of pathologies of the spine to exclude displacement of the vertebrae in the futurepreventive measures must be followed. In this case, doctors recommend limiting the vertical 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 do exercises, gymnastic exercises, and play sports. When lifting weights, do not make sudden upward movements, it is recommended to sit down and then lift the load.
Displacement of the vertebrae today occurs in many people, especially those who are engaged in physical activity. This pathology can be cured, the main thing is to see a doctor in time to establish a diagnosis.
