Pp for lumbarization and sacralization by Dr Dhruv Taneja Assistant Professor

a ppt on spinal congenital problems

1. 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 .

2. 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.

3. T his 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

4. In some cases complaints like Back pain Inflammation Swelling S tiffness of back Muscle spasms I ncreased risk of injury Inter-vertebral disc problems with radiculopathy.

5. 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

6. Some may be asymptomatic. Patients with sacralization are more prone towards back problems than those of lumbarization .***** Signs and symptoms

7. 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

8. Mainly X-Rays CT scan MRI Diagnosis

9. Medications Surgical Rehabilitaion Treatment

10. NSAIDS SMR Steroid injection for severe pain and discomfort Medications

11. Surgical excision surgeries are opted where the symptoms are severe. Surgery

12. Electrical modalities Specific treatment Rehabilitation

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

14. Exercise regimen Muscle strengthening Muscle stretching Core strengthening exercises Manual therapy Specific treatment

15. Revision time Any Questions ???