Pp for lumbarization and sacralization by Dr Dhruv Taneja Assistant Professor

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Lumbarization What is Lumbarization? The human spine is composed of vertebrae namely, cervical, thoracic, lumbar, sacral and the coccyx at the lower end. There are 5 lumbar vertebrae and 5 fused sacral vertebrae, which are based in the region of middle and lower back and facilitate movement of that part .

Transcript of Pp for lumbarization and sacralization by Dr Dhruv Taneja Assistant Professor

Lumbarization

What is Lumbarization?The human spine is composed of vertebrae namely,

cervical, thoracic, lumbar, sacral and the coccyx at the lower end. There are 5 lumbar vertebrae and 5 fused

sacral vertebrae, which are based in the region of middle and lower back and facilitate movement of that part .

Lumbarization of S1 or lumbarization of first sacral vertebra is a condition in which the first sacral vertebra is not completely attached to its fused sacral components but instead this first sacral vertebra appears like the other lumbar vertebrae.

It is also called as an extra vertebra, additional lumbar vertebra or transitional vertebra. It occurs due to non-fusion of first and second sacral segments.

This lumbarized S1 vertebra may also have a disc like the other lumbar segments or may have a disc space that remains underdeveloped.

This lumbarized S1 vertebra is not completely a fused

sacral segment nor does it become a normal lumbar segment.

This makes it difficult to accommodate the additional vertebral joint while performing daily tasks and may make this vertebra more vulnerable to injury and joint irritation.

With advancing age and activities, the lumbarized first sacral vertebra can find it difficult to cope and may become an area that triggers pain, discomfort or may remain prone to injury.

Signs and symptoms

In some cases complaints like1. Back pain2. Inflammation3. Swelling4. Stiffness of back5. Muscle spasms 6. Increased risk of injury 7. Inter-vertebral disc problems with radiculopathy.

Sacralization of L5 or sacralisation of fifth

lumbar vertebra is a congenital anomaly, in which the lumbar vertebra, mainly its transverse process, gets fused or semi-fused with the sacrum or the ilium or to both.

This fusion can occur in one or both sides of the body.

Sacralization leads to fusion of the L5 (fifth lumbar vertebra) and S1 (first sacral vertebra) and the inter-vertebral disc between them may be narrow.

Sacralization

Some may be asymptomatic.

Patients with sacralization are more prone towards back problems than those of lumbarization.*****

Signs and symptoms

Due to the semi fused or bilaterally fused L5

vertebrae to S1, the first thing to get compromised is mobility unlike lumbarization.

All the efforts are upon L4 now which will not be able to cope up with the stresses of load bearing like L5.

More wear and tear of intervertebral joints can take place at L4-L5 and L5-S1 level due to reduced disc space.

Can lead to IVDP which may further require surgical intervention.

Why

Mainly X-Rays CT scan MRI

Diagnosis

Medications Surgical Rehabilitaion

Treatment

NSAIDS SMR Steroid injection for severe pain and

discomfort

Medications

Surgical excision surgeries are opted where

the symptoms are severe.

Surgery

Electrical modalities Specific treatment

Rehabilitation

Spinal traction IFT TENS U.S.THERAPY SWD LASER MWD Spinal corset Rest

Symptomatic treatment

Exercise regimen a. Muscle strengtheningb. Muscle stretchingc. Core strengthening exercises

Manual therapy

Specific treatment

Revision time

Any Questions ???