Sacralization of the L5 vertebra

In a healthy person, the spine consists of 24 vertebrae, which are divided into three sections, the sacrum and the coccyx. Its development begins in the womb (at about the 8th week of pregnancy) and continues until the age of 20-25. Sometimes, under the influence of a number of negative factors, this process is disrupted, which leads to pathological changes in the structure of the spinal column. One of these pathologies is called sacralization - it is localized in the area of the fifth lumbar vertebra (L5) and can lead to unpleasant health consequences.

Sacralization of l5 vertebra

General description of sacralization

Between the first sacral and fifth lumbar vertebrae is the most powerful intervertebral disc . It is necessary in order to reduce shock absorption of the entire spinal column when walking, running and other movements. The intervertebral disc prevents pinching of the nerve endings in the lower parts of the spine.

When a patient experiences sacralization of the L5 vertebra, the disc can no longer cope with the incoming load , which ultimately leads to severe tension in the entire skeletal system.

Because of this, pinching of the nerve roots is observed, which can cause pain in the lower back. Subsequently, the load on the spine leads to its destruction, which can cause osteochondrosis, arthritis and other disorders.

There are several forms of sacralization of the L5 vertebra.

Full . Complete fusion of the vertebrae is observed.
Partial . Small bone arches or processes are formed between adjacent sections, which reduces their mobility.
Deep . The L5 vertebra penetrates deeply into the sacral region, but there is no bony fusion between the spinal regions.

Sacralization - fusion of the last lumbar vertebra with the first sacral

Traumatologists also distinguish between true and false forms of the disease. The described forms are considered true. With a false type of disorder, mobility is reduced due to large deposits of salts in the ligaments. This type of disorder is observed in older people.

Attention! You can distinguish the true form from the false one using x-ray examination. There, salt deposits or the presence of bone and cartilaginous tumors are clearly visible.

Symptoms

The manifestation of symptoms may vary, depending on the form and degree of neglect of the disease. Such an anomaly may not appear for a long time. Basically, the first signs of pathology appear after 20 years, the key symptom being pain. Sacralization of the vertebra is characterized by the following manifestations:

Lumbar pain;
The appearance of tension in the back while sitting, lying for a long time or going down stairs;
The cauda equina phenomenon can transmit sharp shooting pain to the legs, as well as a numbness and burning sensation from the buttock area throughout the sciatic nerve;
There may be a loss of sensory functions of the skin on the legs, in the perineal area, and interruptions in the functionality of the pelvic organs.

With such a disease, it is difficult for people to bend over. Manifestations of the disease may be minor, causing slight discomfort when moving. Gradual progression of the pathology without treatment leads to the first manifestations of the anomaly.

Risk factors and causes of development

Today, the problem of sacralization has affected approximately 15% of the male and 7% of the female population. The anomaly of the true type is exclusively congenital.

The following factors can influence the formation of such a disease inside the womb::

insufficient or excessive calcium intake;
poor maternal nutrition during pregnancy;
the use of medications that can cause improper formation of bone tissue in the fetus.

After 50-60 years, only a false type of sacralization occurs , characterized by the deposition of calcium salts. As a result, significant pain occurs in the lumbar region. The risk group for this form of disorder includes patients with osteochondrosis, osteoporosis, curvature, kyphosis and other problems in the spinal column.

Complete and incomplete sacralization of the L5 vertebra

Sacralization of the L5 vertebra can be of three types:

complete sacralization is characterized by the absence of cartilaginous intervertebral discs, the radicular nerves extend through the foraminal openings and are protected from compression by bone tunnels;
incomplete sacralization of l5 is characterized by the presence of remnants of the intervertebral disc, mobility is impaired, the radicular nerves are surrounded by fibrous tissue;
false incomplete sacralization of the vertebra - the formation of osteophytes and exostoses, which prevent the mobility of the vertebrae, but do not ensure their complete fusion with each other.

If incomplete sacralization is detected, then it is possible to restore full mobility of the spine and stop this destructive process. With complete fusion of the vertebral bodies, it is only possible to conduct rehabilitation courses. They eliminate the risk of developing destruction of the remaining parts of the spine.

Consequences of sacralization

In the absence of treatment for sacralization, the intervertebral discs of the lumbar region may be destroyed. If you do not monitor the patient’s condition and refuse treatment, the following problems may develop:

destruction of the intervertebral discs that are located above the affected area;
a large load on the spine, provoking the formation of curvatures, arthritis, osteochondrosis;
pain syndrome, which, taking into account the complications of the condition, can be quite pronounced and require drug blockades.

In the presence of L5 type sacralization, pain is localized in the lumbar region, sometimes this condition is called “horsetail”.

But gradually the pain syndrome begins to spread throughout the spine, which leads to difficulties in moving and performing basic movements - jumping, long walking, descending stairs.

Often, with pathology of the lumbar region, cauda equina syndrome occurs

How to recognize sacralization or lumbalization?

A visual examination of the patient can give little help in making a diagnosis such as “lumbarization” or “sacralization.” Most often, the presence of a congenital pathology becomes known from the results of an MRI of the lumbar region or radiography, when an adjacent spinal disease, for example, scoliosis or lordosis, is diagnosed.

There are a number of indirect signs that suggest the presence of sacralization or lumbarization:

Various pains in the sacral and lumbar spine
Unsteady gait, sharp pain when running or changing body position
Pain when going down stairs and doing physical activity
Pain syndrome decreases with a horizontal position of the body and increases with a vertical position
An increase or appearance of pain when jumping in place at the moment when the heels touch the floor
Numbness or burning in the leg that precedes the onset of pain
Concomitant diseases of the spine - scoliosis, kyphosis, lordosis, osteochondrosis, etc.

If you have any questions, ask our specialist! Ask a Question

Symptoms and diagnosis

The disease can develop in three ways:

In the first option, no symptoms are observed . The disease is discovered randomly. In most cases, there are no signs of sacralization if the patient is diagnosed with complete fusion of the spine.
In the second case, early development of pathology is observed . With it, partial mobility of the vertebrae is observed. The patient is diagnosed with a sciatic or mixed form of sacralization, in which there is injury to the spinal nerve in the form of pinching and bruising. The disease occurs at approximately 18-20 years of age. The patient complains of pain after physical activity, when bending the body and when jumping. The pain is relieved by lying down and returns when sitting on your heels.
In the third case, late sacralization is observed . It is characterized by the occurrence of pain due to problems in the joints and column of the spine. This stage occurs after about 50 years. Pain is most often observed only in the lumbar region.

If a patient exhibits signs of sacralization of the L5 vertebra, diagnosis can be carried out independently or by a doctor. When independently determining the diagnosis, the patient is recommended to stand on the floor and try to bend with straight legs towards his toes. If this is done with great difficulty and there is a long distance left to the floor, a violation may be suspected.

After this, it is imperative to seek advice from a traumatologist. He makes the diagnosis through x-ray examination of the sacrolumbar region. Using an image of the patient, the doctor counts the vertebrae and determines the extent of the damage.

To diagnose sacralization it is necessary to take an x-ray

Attention! Sometimes experts recommend magnetic resonance imaging or computed tomography. These methods are more accurate and make it possible to determine the degree of fusion of bone and cartilage tissue, even in the presence of small areas of connected tissue.

Video: “Structure and functions of the spinal column”

Causes

The direct cause leading to lumbarization and sacralization of the sacrolumbar region has not been fully elucidated by specialists. According to some researchers, such a pathology develops during the formation of the embryo as a result of changes in the anlage points of ossification of the fetus. Sacralization develops when there is an excess of ossification points, and lumbarization develops when there is a lack of these points. Other causes include various forms of spinal curvature and traumatic events.

Treatment of the disorder

Drugs

Therapy to eliminate sacralization of the 5th vertebra involves the use of painkillers and anti-inflammatory drugs . For treatment, it is recommended to use only those medications that belong to the class of non-steroidal ones. They relieve pain well and eliminate swelling from damaged tissues.

Painkillers are used only for severe pain. The blockade is carried out using Novocaine and Lidocaine. First, the patient is placed on his stomach with his arms outstretched.

After this, the needle insertion site is pricked with any painkiller. Then a long needle is taken, which is inserted deep into the intervertebral space, Novocain is squeezed out of the syringe, which shows great effectiveness. After insertion, the needle is removed and the patient must remain under the supervision of a specialist for two hours.

When using non-steroidal anti-inflammatory drugs, injections are recommended . They quickly penetrate the bloodstream and reach the affected area. Diclofenac is prescribed for treatment. Doses of active substances are selected individually for each patient, taking into account the severity of sacralization and the form of pathology.

Surgery

Did you know that...

Next fact

Surgical intervention is prescribed if the fusion of the spine has led to severe pinching of the nerve roots.

The patient constantly experiences severe pain, which even drug blockades cannot eliminate. During surgery, the surgeon cuts through the connected bone or cartilage tissue.

A small graft is placed at the incision site. It provides the necessary mobility to the spinal column and eliminates compression of the nerve roots. The graft becomes an analogue of an intervertebral disc.

Exercise therapy, massage and additional methods

Physical therapy is prescribed to relieve pain and prevent the development of osteochondrosis . It consists of performing exercises that do not put excessive stress on the lower back, but strengthen the muscular corset. The complex is selected separately for each patient and is initially performed under the supervision of a specialist.

Massage also has an analgesic effect. Such procedures also make it possible to improve muscle tone and strengthen them . Sessions are conducted by a qualified massage therapist.

To relieve acute symptoms, 10-15 therapy sessions of 10-20 minutes each are recommended, taking into account the severity of sacralization, symptoms of the disorder, and the sensitivity of the patient.

When fusion of the L5 and S1 vertebrae occurs, it may be necessary to wear an orthopedic corset. Wearing a corset helps. It is not prescribed to all patients, but only to those who begin to develop curvature. In this case, the doctor decides to temporarily use a support structure. It is necessary to wear it for such a violation for several hours. The duration of treatment is determined only by the traumatologist.

Magnet and ultrasound treatment is aimed at eliminating pain and inflammation from spinal tissues. 5-10 sessions may be prescribed for therapy. The procedure usually lasts from 5 to 15 minutes, it all depends on the patient’s condition.

For severe pain, electrophoresis with novocaine is prescribed . The procedure involves the use of small electrodes that are placed on the sore spot. They are first wrapped in fabric soaked in novocaine. This treatment has more advantages than a blockade, since spinal trauma is eliminated.

Video: “Anatomy of the human sacrum”

Home treatment

Treatment at home is usually not carried out, since there are simply no folk remedies that could remove the consequences of vertebral fusion.

You can use small methods to relieve pain , but only after the doctor's permission.

Gent pressure on the sore spot. It is best to do them with your thumbs for 3-5 minutes.
Apply a small heating pad to the painful area, which accelerates the blood and reduces the intensity of pain. Treatment should not last more than 5-10 minutes.
Applying heated salt. It is pre-wrapped in gauze. Therapy is also carried out for 5-10 minutes.
Rubbing the skin with ginger. It relieves inflammation and relieves pain. Procedures can be performed 2-3 times a day.

Attention! Heat treatment can be carried out only if you are confident in the complete absence of the inflammatory process. Therefore, it can be used with a confirmed diagnosis without complications.

Prevention of concomitant diseases of the spine during lumbarization and sacralization

At the MART medical center, you can consult a neurologist and draw up recommendations for eliminating the negative consequences of lumbarization or sacralization. If necessary, a physical therapy doctor will develop for you a plan of individual sessions that will help prevent the development of pain and improve the functioning of the body as a whole.

The article was reviewed by Doctor of Medical Sciences, Professor Grigory Isaakovich Shvartsman, Northwestern Medical University. I.I. Mechnikov.

How to treat pathology

To eliminate congestion, the patient is given a course of physical therapy.
If the radiologist has confirmed the presence of changes characteristic of sacralization, conservative or surgical treatment is prescribed. If the pathology is asymptomatic, monitoring the condition is sufficient.

When pain is present, conservative measures are prescribed:

taking oral medications from the group of non-steroidal anti-inflammatory and analgesics;
carrying out blockades with stronger drugs, for example, from the group of glucocorticoids or Novocaine;
attending physical therapy sessions: electrophoresis with painkillers, ultrasound therapy, magnetic and laser therapy.

To prevent stagnant processes and strengthen the structures of the affected area, therapeutic massage and physical exercise are required. If possible, the patient is sent for treatment to sanitary-resort conditions.

If the results of CT and MRI reveal pathological changes in bone and soft tissues that cause severe back pain that cannot be treated with conservative methods, a planned operation is performed:

the doctor removes the process that has formed a movable or immobile joint;
then spinal fusion is performed;
An artificial disc is installed in place of the formed vertebra.

To accelerate the regeneration of operated tissues, it is recommended to undergo a course of physiotherapeutic procedures. If pain is present, take painkillers.