Spondylolysis is the anomaly of the spine, in which there is no bone fusion of the vertebral bodies and arches. This files most often observed in the spondylolysis of the fifth lumbar vertebra – l5, but its causes can be different.
In the diagnosis of this disease is rather complex, since it practically does not manifest itself, and different symptoms appear only when the disease is already “started”. An additional difficulty is that spondylolysis is often the cause of spondylolisthesis, because it is more interesting not as an independent disease, namely in terms of risk of transition to another, more serious disease.
Of course, this disease is not the only possible cause of the development of spondylolisthesis, but that this form (referred from spondylolysis) is “true spondylolisthesis”. Also cause displacement of the vertebrae can be injuries and different diseases of the spine degenerative-dystrophic nature.
The types of the disease
Occurs unilateral (non-Union one arch) from one side or the other, as well as bilateral spondylolysis. Young people up to 20 years, this disease occurs equally, regardless of gender, but among the older patients significantly more than men.
Generally there are three kinds of this disease:
Congenital spondylolysis usually develops after naseleniya two nuclei of ossification, which was to form the missing half of the arc. Purchased usually develops under the influence of external factors. It could be excessive physical exertion, which on a background of dysplasia of the vertebrae or eating disorders of bone tissue, which lead to the fracture of the arc, etc. it can Also be simply a consequence of the injury. Mixed type of the disease involves a combination of congenital and acquired.
What are the symptoms spondylolysis?
As we have said, clear and well-marked symptoms of the disease not. Sometimes it is diagnosed by chance in the survey, but more often – in the development of spondylolisthesis.
But as the symptoms of this disease there are such signs:
- the appearance of periodic moderate pain, which are localized in the lumbar region. They usually appear after exercise – a long walk, long sitting in a forced unnatural position, sudden waking up, exercise, etc. it Should be noted that this is a fairly “common” symptom that occurs in many diseases of the spine;
- the feeling of stiffness of movement in the lumbar region;
- the displacement of one of the vertebrae in the lumbar region forward in relation to neighboring vertebrae. In fact – it is a manifestation of spondylolisthesis that requires serious examination and prompt treatment.
It can be noted that the symptoms of this disease is quite common, which leads to difficulties in the diagnosis of this disease. During the examination the doctor drew attention to some additional symptoms. Thus, in the process palpation revealed tenderness to the spinous process, and the physician may note an increase of lumbar lordosis and lateral position of the sacrum. But even x-ray cannot always detect the problem – in this case, you need a very specific body position in the study (¾ view). To clarify the diagnosis in such a situation allows computed tomography.
How to treat this disease?
The only treatment method that allows you to fully get rid of this problem is surgery. But since the disease does not manifest itself by any symptoms, even if the detection of this disease most patients are totally against surgery and trying to find a less radical methods of treatment. However, with the bilateral form of this disease is still required surgery (osteoplastic fixation of the sacral and nizhnespasskoe spine), as too great a risk of developing spondylolisthesis.
The main objective of conservative treatment is strengthening of the muscle corset (in this case – back muscles and abdominals), thereby reducing the risk of instability of the vertebrae. This is achieved by using special therapeutic exercises and specific physiotherapy. One of the major problems is the lack of symptoms, because “nothing hurts” – patient does not belong to the treatment process seriously and eventually just forgets about the need for such prevention.
If you develop acute pain syndrome (which, incidentally, happens very rarely), it is possible to use corsets and use of drug therapies. But in this case, often we are talking about spondylolisthesis, which is a much more serious treatment.