Lumbarization of the S1 vertebra belongs to the category of rare anomalies, which appears as a result of deviations in the development of the spine. Pathology is diagnosed in only 2% of people who present with low back pain. Often, this deviation from the norm does not manifest itself in any way for many years and can only be detected during the annual physical examination. It is important to conduct treatment in a timely manner, which will later avoid serious he alth complications.
General concept of anomaly
In a he althy person, the sacral spine is a single fused bone at the bottom of the spine. When moving, the entire load falls on it. With a normal structure of the lumbar region, 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 underdevelopment of the initial sacral segment (S1). ATas a result, this vertebra does not connect with other bone structures and forms a separate sixth vertebra (L6) in the lumbar region.
According to the anatomical structure, it does not differ from a he althy 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 found that it had practically fused with the sacral region, the diagnosis still remains unchanged.
When lifting weights, the formed part of the spine shifts as a result of improper load distribution. This is characterized by pain in the lumbar region. If left untreated, the anomaly leads to the development of serious complications.
Classification
In medicine, there are several classifications of this anomaly of the spine.
Depending on the degree of discharge of the first vertebra of the sacrum, the following types of pathology are distinguished:
- Complete lumbarization of the S1 vertebra. In this case, 6 separate lumbar vertebrae are clearly distinguished on 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 anomalous change retains a connection with the sacrum and partly with the lumbar region, despite the appearance of tears. The development of pathology is characterized by partial immobilization of the lower back, accompanied by pain.
Depending on the location of abnormal changesthe following varieties exist:
- left or right lumbarization of S1 vertebra;
- Bilateral separation of S1 vertebra.
Reasons
It has not yet been possible to establish the exact cause of the development of the anomaly. But experts insist that the main provoking factor is 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 pregnancy;
- pregnancy over the age of 30;
- taking medication without consulting a gynecologist;
- predisposition at the genetic level.
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, when planning a pregnancy, it is so important to normalize nutrition, give up bad habits and protect yourself from infectious diseases at least six months before the intended 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 aging process begins in the body.
Clinical signs of lumbarization of the S1 vertebra may differ depending on the formpathological process.
| Lumbarization shape | Characteristic symptoms |
| Lumbar |
|
| Ischial |
|
You can recognize the presence of an anomaly by the sharp pain that arose when jumping with bent knees and trying to land on your heels. But this diagnostic method needs confirmatory studies. Therefore, only a doctor can make an accurate diagnosis.
How dangerous is an anomaly of the spine?
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 to refuse treatment of S1 lumbarization.
Ignoring the problem can lead to the development of the following pathologies:
- osteochondrosis;
- scoliosis;
- kyphosis;
- spondylosis.
In children, a mandatory medical examination helps to identify a pathological change upon admission to a preschool and school institution. If appropriate treatment is not carried out at this age, then this will provoke the progression of other abnormalities against the background of underdevelopment of the sacral region.
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 functioning of the pelvic organs.
Diagnosis
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 for detecting lumbarization of the S1 vertebra on x-ray:
- gap in the region of the upper sacral vertebrae;
- reduced length of the spinous process that closes the lumbar vertebra;
- the presence of an additional shadow in the area of the fifth vertebra of the lumbar;
- vertebral 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. A consultation with a neurologist is also required, which will allow to excluderadicular syndrome, sciatica, lumboischialgia.
Basic treatments
Compulsory therapy is necessary if a person has discomfort in the lumbosacral region, which limits mobility and negatively affects the quality of life. Also, treatment is carried out if abnormal changes in the spine provoke the development of complications.
Medication is only prescribed to relieve clinical symptoms.
Main types of drugs:
- chondroprotectors ("Don", "Artra");
- correctors of microcirculation ("Actovegin", "Trental");
- NSAIDs ("Diclofenac", "Ketoprofen");
- muscle relaxants ("Tizanidin", "Mydocalm").
The course of therapy and the dosage of drugs are prescribed by the doctor, depending on the type of anomaly established and the severity of symptoms during the exacerbation.
Further treatment regimen includes the following procedures:
- wearing a corset;
- acupuncture;
- physiotherapy;electrophoresis;
- massage;
- paraffin applications;
- ultrasound therapy.
Sanatorium and preventive treatment is also recommended.
Features of physiotherapy exercises with lumbarization of the S1 vertebra
One of the methods of treatment is also physiotherapy exercises, but possible exercises are pre-agreed with a rehabilitation specialist.
Therapeutic exercises with lumbarization of the S1 vertebra are carried out in a horizontal position with bent legs, but the feet should remain on the floor. Vertical exercises are not recommended, as any tilts or turns can provoke the development of an unstable form of pathology.
When diagnosing a disease in children, physiotherapy exercises are supplemented with corrective exercises that help correct the curvature of the spine in the lumbar region.
Surgery
Surgical intervention is extremely rare if the patient has acute pain that does not go away even after taking painkillers. An indication for surgery is also impaired spinal stability.
The purpose of the procedure is artificial fusion of bone segments. To do this, the vertebrae S1 and S2 are fixed between themselves with an iron plate, and with the help of a special corset, the lumbosacral region is immobilized.
If artificial fusion is impossible, the S1 vertebra is fixed directly to the sacrum, and a special disc is placed between the bone segments S1 and S2.
Useful recommendations on how to live with complete and incomplete lumbarization of the S1 vertebra
Patients with these pathological changes in the structure of the spine are advised to follow certain rules throughout their lives. These restrictions help to reduce the load on the damaged segment and exclude the development of complications:
- Sleep on hardmattress.
- It is necessary to exclude lifting heavy objects both at home and when choosing a professional activity.
- If you need to pick up an object from the floor, you should first sit down, and only then pick it up. But it is best to ask loved ones for help.
- Physical activity and sports limit.
Adhering to these recommendations, a person with this abnormal change in the spine will remain able to work for many years.
Reviews
Lumbarization of the S1 vertebra, according to doctors, does not pose a danger to human life. But the pathology requires timely treatment, which will eliminate the likelihood of developing secondary changes. The prognosis of specialists with both conservative therapy and surgery is favorable.
But you should understand that throughout life a person must comply with the restrictions associated with physical activity. Only careful attention to one's he alth will help maintain the full ability to move around and lead a normal life.
