Spondylolisthesis of the cervical and lumbosacral regions

Today, almost all middle-aged and elderly people know from personal experience what vertebral displacement is. Each of them at least once experienced severe back pain, which was preceded by a click somewhere in the spine, heard at the moment, for example, of stretching, and then stiffness in the body.

That same sound signaled the displacement of the body of one vertebra relative to another forward or backward. If such displacements occur regularly, this may signal spondylolisthesis, a disease of the spine that can lead to deformation and other unpleasant and painful sensations.

• Classification of vertebral displacements
• Reasons for appearance
• Symptoms
• Consequences
• Diagnostic methods
• Our treatment methods
• Prevention

Classification of vertebral displacements

There are spondylolisthesis:

• Stable – when the relationship between the vertebrae (displaced and located below) does not change during movement.
• Unstable - the relationship between the vertebrae changes during movement.

There are several types of vertebral displacements:

• Antelisthesis - moves forward;
• Retrolisthesis – moves backward;
• Lateral displacement (slipping).

Today, antelisthesis is most often diagnosed in patients.

There are two degrees of displacement:

• Linear;
• Corner.

Stages of displacement:

• First, the strongest and at the same time weakest point in the human spine is the lumbar region. It is in this area that pain, familiar to many, appears after heavy physical exertion or a long stay in a static position (standing in line, sitting at a table). Such pain is episodic, rarely does anyone come to the doctor with it. In this case, the displaced disk moves out of its normal position by 25% relative to its neighbors.
• The second is that the disc is already shifted by 50%; pain is felt much more often in the lumbar region, including after playing sports or lifting weights.
• Third, a person suffers from constant pain that does not subside even in a calm state. At this stage, the shift occurs by more than 50%, the structure of the vertebrae changes, the nerve roots are pinched, and the structure of the cartilaginous layers is gradually destroyed.
• Fourth, the disease becomes irreversible. A person feels severe pain not only in the lower back, but also in the knees, hips, legs, arms, hands and feet periodically become numb, spasms in the back muscles may be observed, it becomes impossible to walk or stand for a long time, and the quality of life noticeably deteriorates.

Without promptly seeking help from doctors and delaying the treatment process until the last stage, a person may lose sensitivity in the limbs or become disabled.

Pathogenesis

Most often, the fifth lumbar vertebra is subject to displacement; this happens much less often with the fourth.

Failure of the connection of the vertebrae as a result of a violation of the integrity of their arches or underdevelopment of the articular processes leads to pathological mobility. As the disease progresses, destructive changes occur in the intervertebral disc: the nucleus pulposus is absent, and the annulus fibrosus dissects. Over time, a gap forms in the disc, into which nearby tissues penetrate.

In addition to the disc, the structure of the bodies of the displaced and underlying vertebra also suffers. The terminal plates become thin, the spongy substance loses its beams, and many cystic formations appear. All these changes contribute to the destruction of the vertebral body. In the terminal stages of the disease, the intervertebral disc may be completely absent. And the resulting joint is subject to arthrosis, which is quite severe.

The aggravation of the process leads to a narrowing of the spinal canal, which at this level contains the “cauda equina” - the final section of the spinal cord.

The basic principle of the biomechanics of displacement of the lumbar vertebrae is that the pelvis gradually tilts backward, and the lumbar lordosis (natural curvature, forward deflection) increases.

Symptoms

The human body instantly signals with pain any disturbances occurring in it. The fact that one of the vertebrae has shifted in some part of the spine becomes known immediately, since the person begins to feel a whole range of very unpleasant sensations, although they may not all appear at the same time.

The degree of displacement and its location affect the symptoms, but the most important and sure sign of a problem is always acute pain.

Displacements in the cervical spine manifest themselves:

• Neck pain and headaches;
• Inability to make full tilts and turns of the head;
• Joint crunching in the spine during movement;
• Numbness of the fingers, pain in the hand, the appearance of “goosebumps”;
• Numb tongue and throat;
• Ear noise, VSD, pressure surges.

Displacements of the thoracic region:

• There is pain between the shoulder blades;
• The back muscles spasm;
• Left back pain (similar to heart pain);
• It is impossible to take a deep breath of air, the sternum is stiff.

Lumbar displacement:

• Sharp and sudden pain in the lumbar region;
• The sciatic nerve can become pinched and inflamed;
• Radiculitis;
• The ability to move is limited;
• Muscle spasms, numbness in toes, goosebumps.

A person does not always find out about injuries to the spine immediately. In rare cases (for example, after a car accident), symptoms of displacement or injury may appear after a couple of days, several months or years. And even if a person only occasionally feels mild pain in the spine, which goes away on its own, then with a heavy load or an unsuccessful tilt, the situation can worsen, as the degree of displacement of the vertebra increases. Therefore, it is important to contact specialists in a timely manner and undergo examinations.

Consequences

Displacement of the vertebrae not only causes discomfort to a person, but also affects various organs and parts of the body. Each part of the spine provokes its own diseases or painful sensations.

Cervical region:

• Migraine, headaches, dizziness, memory loss;
• Problems with hearing, vision, fainting;
• Neuralgia, eczema, acne;
• Adenoids, hay fever;
• Various throat diseases;
• Thyroid diseases.

Thoracic section:

• Breathing problems;
• Diseases of the heart, chest, pain in the hands;
• Lung diseases;
• The gallbladder, liver, and stomach suffer;
• Anemia, poor circulation;
• Ulcers, gastritis, allergic reactions;
• Infertility (in some cases).

Lumbar:

• Constipation, colitis;
• Convulsions;
• Menstrual irregularities in women, impotence in men;
• Lumbar pain;
• Cold feet, leg muscle cramps, poor circulation.

Diagnostic methods

• X-ray - makes it possible to examine the condition of the vertebrae and discs, as well as find out the degree of mobility of individual segments of the spine. An X-ray of the cervical spine should be performed for any injury or suspicion of it, even if the person is unconscious.
• MRI – magnetic resonance imaging. This research method is often used to study the condition of the lumbar and sacral spine. With its help, you can assess the condition of the discs between the vertebrae and joints. The use of MRI avoids lumbar puncture, which was previously often used to diagnose spinal conditions.
• Computed tomography (CT) - makes it possible to examine the lower back for the presence of disc herniations.

Our treatment methods

Treatment of displacement begins only after a detailed examination of the spine!

Chiropractor massage the female patient spine and back

We use the latest diagnostic systems and effective non-surgical methods for treating vertebral displacement. It is possible to completely get rid of symptoms and stop further development of the disease only with an integrated approach to treatment.

At the first appointment, the doctor diagnoses back pain, assesses motor function, the condition of the spine, checks muscle strength, evaluates reflexes, skin sensitivity, conducts functional tests, identifies changes in the musculoskeletal system, and determines the stage of the pathological process.

If necessary, additional examinations are prescribed to make a diagnosis:

• Radiography
• CT (computed tomography)
• MRI (magnetic resonance imaging)
• Laboratory research
• Consultations of narrow specialists

Pain relief is possible already at the first session using nerve root blockade, acupuncture, biopuncture, vacuum therapy, hirudotherapy, and certain massage techniques.

Pain relief does not treat the cause, but removes the reflex muscle spasm, relaxes the muscles and releases the pinched nerve root.

After a complete diagnostic procedure, the doctor draws up an individual treatment plan. During treatment, the regimen may change.

• Orthopedics (production of orthoses)
• Physiotherapy
• UVT
• Massage
• Exercise therapy
• Manual therapy
• Hirudotherapy

Our task is to help the body launch and accelerate natural recovery processes. Treatment of the disease is completed when the load on the spine is removed, metabolic processes and blood supply are restored.

Surgery is a last resort measure that is required only if the disease is advanced or noticeably progressing. If necessary, we cooperate with leading clinics in Russia and abroad and provide referrals for a consultation with a surgeon.

Remember, self-relief of pain with pharmacological drugs, physiotherapy or folk remedies only allows you to temporarily suppress the symptoms, but does not stop the development of the disease.

Forms of spondylolisthesis

Depending on the direction in which the spinal fragment shifts, there are two main forms of the disease:

• anthespondylolisthesis or sliding of the overlying vertebra forward (relative to the underlying one);
• retrospondylolisthesis or backward displacement of a vertebra.

A rare option is laterospondylolisthesis, in which the spinal discs move apart to the right or left of each other. Any form of spondylolisthesis is accompanied by pain, stiffness, and limited mobility.

results

The reputation of the clinic is strengthening and growing every year!

The ADANAYA Clinic, specializing in the treatment of diseases of the spine and joints, has a team of specialized specialists in the treatment of vertebral displacement. For more than 7 years, we have been successfully restoring the health of our patients, restoring them the freedom and joy of movement without pain. Treatment at the clinic gives positive results in 98% of cases, which is confirmed by reviews of our specialists.

We do not leave you alone with the disease. We heal with our hands and heart.

Physical therapy to help!

The selection of a set of necessary physical exercises for a patient with spondylolisthesis is carried out only by a specialist!

More often, static exercises and complexes aimed at stretching tendons and muscles are recommended.

It is forbidden:

• Perform exercises when pain worsens
• Exercise in a vertical position.
• Increase the tilt of the body by more than 20 degrees (in this case, repeated displacement is possible).

If conservative treatment methods do not lead to the expected result, the doctor may recommend surgery. To avoid surgery, if there is any suspicion of vertebral displacement, it is necessary to urgently be examined by a specialist!

Prevention

Doctors at the ADANAYA clinic recommend:

• Moderate but regular physical activity, physical activity and compliance with other healthy lifestyle rules.
• When working at a desk or computer desk, watch your back position. You need to sit straight, and the height of the chair should be adjusted (seat at knee level). You can place a small bench or other support under your feet.
• If the work is standing or you have to stand in a long line, it is important to change your position often (every 10 minutes). Walking in place and rolling from heel to toe also helps.
• When lifting and moving heavy objects, it is important to distribute the weight correctly. It is best to divide the load into parts so that you can carry it not in one hand, but in two. If you need to lift something heavy, then it is not your back that should bend, but your knees, so that there is no strain on the lower back. It is better to carry cargo over long distances in a backpack, which will be located on the back, and not in a bag over the shoulder or in one hand (this is safer for the spine).
• You also need to sleep properly. The bed should be semi-soft, and instead of a cushion under the head there should be a rectangular pillow.
• Playing sports will also not hurt, but instead of running it is better to choose race walking, since it is less traumatic for the spine.
• It is recommended to avoid drafts and hypothermia, as this may cause additional tension in the muscles adjacent to the spine, which creates additional conditions for illness.

Rehabilitation

A rehabilitation period after reduction is necessary for every patient. During this time, he should engage in moderate physical activity, perform gymnastic exercises and regularly attend physiotherapeutic procedures that will help him restore and strengthen his muscle corset.

The first few days after recovery, the patient should adhere to a gentle regimen: no physical activity and relaxing massages. In addition to physiotherapeutic procedures and exercises, the doctor prescribes a set of medications that relieve pain and restore damaged structures of the spine.

These medications include:

• painkillers and anti-inflammatory drugs - a group of drugs that are prescribed by a doctor in the form of ointments, injections, tablets and other dosage forms to relieve acute severe pain;
• calcium supplements - a group of medications that include calcium and vitamin D3, which help strengthen the skeletal system;
• B vitamins – a vitamin complex that helps restore the sensitivity of nerve fibers and improve the functioning of the nervous system.

B vitamins are available in different dosage forms: ampoules for intramuscular administration, tablets and capsules. The patient must adhere to the course for the medicine to begin to have a therapeutic effect.