Lumbar spondylolisthesis is clinically called lumbar spondylolisthesis . It refers to the relative slippage of two adjacent lumbar vertebrae, that is, a certain vertebral body has slipped relative to its adjacent lower vertebral body. The direction can be toward Forward, backward or sideways.
Patients often present with low back pain and lower limb nerve root compression pain. The pain is often related to excessive activity and exercise.
Symptoms of lumbar spondylolisthesis
Lumbar spondylolisthesis is the relative slippage of two adjacent vertebrae forward or backward. Mainly caused by hereditary, congenital, spondylolysis, degeneration, trauma, pathological and iatrogenic low back and leg pain. In severe cases, bilateral lower limb and bowel dysfunction may occur, combined with vertebrae. Intermittent claudication may occur when the tube is stenotic.
1. Typical symptoms of congenital spondylolysis: Mild patients may be asymptomatic. During the radiograph, it is found that low back pain occurs after exertion, which may be combined with radiating pain in the lower limbs . The pain is relieved at rest. In severe cases, bilateral lower limb radiating pain and pain may occur. Defecation dysfunction.
2. Typical symptoms of degenerative lumbar spondylolisthesis: The incidence rate increases with age, and the incidence site is more common at L4/5, followed by L3/4 or L5/S1. It manifests as low back pain, limited lumbar extension and compression. The nerve root may be accompanied by sciatica . When the L4 nerve root is compressed, the inner side of the lower thigh feels numb and the knee tendon reflex is weakened. When the L5 nerve root is compressed, the outer side of the calf and the inner side of the dorsum of the foot will feel numb, and the dorsiflexion of the toes will be weak. Intermittent claudication may occur when the nerves in the spinal canal are compressed. When the S1 nerve root is compressed, the outside of the foot will feel numb and the Achilles tendon reflex will weaken or disappear.
Treatment methods for lumbar spondylolisthesis
For patients with lower back pain, anteroposterior and lateral X-rays of the lumbosacral region are routinely performed. To determine whether there is spondylolysis and lumbar spondylolisthesis. Patients with lumbar spondylolisthesis below grade II and mild symptoms can be treated conservatively, including medication, physical therapy, and brace fixation. If the patient's nerve compression symptoms are severe, spinal canal decompression, vertebral body reduction and intervertebral fusion can be performed.
1. Drug treatment
1, non-steroidal anti-inflammatory drugs, pregabalin can be added when the nerve pain is severe.
2, neurotrophic drugs, such as methylcobalamin , etc. Pain caused by nerve root edema in the acute stage can be treated with dehydration drugs plus hormones.
2. Surgical treatment
includes repair surgery, decompression surgery, reduction and fixation surgery, and fusion surgery. Clinically, the patient's age, cause of spondylolisthesis, degree of spondylolisthesis, progression trend, degree of lumbar instability, type of pain, and bone quality should be comprehensively considered. Conditions, adjacent segment conditions, surgical approach and other factors, a reasonable surgical approach should be adopted.
3. Other treatments
When you sit for a long time, you should move every 30 minutes . It is recommended to maintain 150 minutes moderate intensity exercise every week. Monitor blood sugar before and after exercise. In order to avoid excessive fluctuations in blood sugar, patients with type 2 diabetes should do physical exercise after meals. People with blood sugar levels of 14 to 16 mmol/L, recent frequent episodes of hypoglycemia or large blood sugar fluctuations, and acute complications of diabetes and severe chronic complications such as heart, brain, eyes, and kidneys should not exercise for the time being.
