Vortex sliding

Synonyms

Spondylolisthesis, gliding vertebrae

definition

At a healthy spine forms this one evenly running S-curve (physiological Lordosis and Kyphosis) out.

The individual vertebrae sit firmly on each other and are made by joints, ligaments and muscles attached to each other and reinforced.

Under the Vortex sliding one understands the slipping of one or more vertebrae of the spine.

In most cases the vortices shift Forward, but they can also to the back or to the side slide there.

Are from vortex slip more often the vertebrae of the lumbar spine affected than the lower back.

Since the vertebral bodies are connected to one another by joints, it often happens that a slipped vertebra pulls several vertebrae with it. From this follows one Spinal instability.

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The spine is difficult to treat. On the one hand it is exposed to high mechanical loads, on the other hand it has great mobility.

The treatment of the spine (e.g. herniated disc, facet syndrome, foramen stenosis, etc.) therefore requires a lot of experience.
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Classification

The vortex can slide in different degrees of severity to be grouped.

At grade I are less than 25% of all vertebrae moved and kick it no or hardly noticeable complaints on.

These symptoms can also be found in Grade II although here already 25 to 50% of the vertebrae are affected could be.

At Grade III can 51 to 75% of the vertebral bodies slipped what to severe discomfort in the person concerned leads.

The course is similar for Grade IV, in which more than 75% of the vertebrae slide away, and to significant problems can lead.

causes

Responsible for the vortex slip are initially degrading changes in the various joints (see also: Degenerative spinal diseases). This applies particularly to the joints that connect the adjacent vertebral bodies with one another above and below.

Due to the severe overload the bone gradually becomes worn and crumbly. As a result, wear and tear can result in a Gap between the vertebral bodies form. The formation of the gap is called in the technical language Spondylolysis designated. The resulting Loosening of the vertebra in its anchorage, allows sliding forward.

It is not uncommon for several vertebrae to slide forward. Factors like Shape, texture and advanced changes to the associated Intervertebral disc can facilitate this process.

Wear and tear and the resulting degradation of the bone substance is the most common reason for vertebral slippage in old age. Are often affected People between the ages of 50 and 60.

The intervertebral disc loses fluid with increasing years of life and thus also its effect as a shock absorber. The surrounding muscles decrease in strength and can no longer adequately stabilize the spine.

Much rarer causes can be inflammation, injuries or tumors of the spine.

Additionally there is some sports that can trigger vortex sliding. In competitive sports, for example, this includes disciplines such as apparatus gymnastics, trampoline jumping or pole vaulting as well as the various throwing disciplines. The Overuse is then very great.

The vortex sliding can also genetically conditioned if there has been a certain instability of the spine since birth, which may be due to Malformations such as the lack of bony prominences on isolated vertebrae.

Symptoms

The patient's complaints are depending on the severity of the vertebral sliding, and the extent of the degenerative process of the affected vertebral joint surfaces.

are less than 50 percent of the vertebrae the patients feel it slips often no pain. Often the vertebral sliding is diagnosed only by chance.

There is a difference between innate and acquired vertebral sliding. Affected, where already known as vertebral slipping since birth is have often the first symptoms at an early age.

Against that Acquired case, the complaints came quite late on, and the cause remains undiscovered for a long time.

Kick while the vertebrae slide no characteristic symptoms on. Pain expresses itself as unspecific back pain. These occur especially suddenly when moving on, and can Belt-shaped from the back to the front Spread out towards your stomach.

Patients often report one Increase in pain when stretching the back.

Additional problems can arise if the dislocated vertebra presses on nerves and pinches them. The patient can then Sensory disorders and muscle weakness in the legs feel.

With such more serious symptoms, a Treatment initiated immediately to avoid deterioration or even permanent damage.

Conservative therapy

Severe complaints can significantly reduce the quality of life with this disease.

By a early appropriate therapy a progression of the vertebral sliding can be prevented and pain can be significantly alleviated.

As part of the conservative therapy the patient is first adequately informed about how he is taking his The spine is specifically relieved in everyday life and at work.

A Physiotherapy and back school offered.

The patient is instructed to use exercises independently even after the agreed physiotherapy. This is very important for the success of the therapy. In addition, he receives information about which movements and sports are suitable, for example the Strengthen back muscles and the Spine more stability to rent.

A relief of the spine and the prevention of a progressive inclination can through orthopedic shoe insoles be prevented. These are given by an orthopedic technician using a prescription individually adapted to the foot.

The application of a Electrotherapy, the current flows through the muscles, relaxes the muscles and relieves pain. An medical therapy support pain reduction.

surgery

An operation may then be necessary if consistent conservative therapy fails showed.

Other indications are a well advanced vertebral sliding over several vertebral bodies or when nerves are already damaged and sensory disorders become worse.

The goal of an operation is that to restore the original anatomical shape of the spine. The slipped vertebra will be pulled back into its actual position by means of screws and rods and fixed.

The stability of the spine is guaranteed again. A additional filling of gaps with titanium or plastic supports the vertebrae and holds them in place.

Aftercare

For the operation to be successful, the The spine was immobilized for several weeks using a corset become.

It takes some time for the vertebrae to ossify in their new position and then to guarantee stability.

Subsequently physiotherapy should be startedto slowly strengthen the surrounding back muscles. Of the Building the muscles affects supportive of healing out.

In rehab, patients learn how they should behave after the operation and which exercises on equipment or in water therapy are helpful for the success of the operation.

After the operation, symptoms such as numbness in the legs or nerve damage are reduced, and the Patients feel a significant improvement.