The lumbociática is the associationón of two síntomas, what are low back pain and ciática. It's a yesíthe apostle, so it means that there are different pathologiesíso they can cause it.
The lumbar pain It is called the one that is located in the regionón that runs from the area of the glúTeos until the first vértebra lumbar, about rib height. This can be mechanicaláunique or inflammatory.
The ciática, for his part, It is called that pain that is caused by irritationón of the nervous thereático, a neurological painático, characterized by severe pain running down the leg and associated with leg cramps, weakness and changes in sensation. In most cases the irritationón originates at the level of the lumbar spine.
Index
types of lumbocytaática
The lumbociática can be classified according toón of the appearance timeón of the síntomas. It is considered that there is a lumbociática when it lasts less than six weeks; and it is considered that there is lumbociática crónica in the event that the sísymptoms last over timeás allá of the three months.
If it lasts between three and six months, is considered to be a lumbociásubacute tics.
Causes of lumbocyática
There are different pathologiesíso that they can cause you to suffer from lumbociática, the main ones being the following:
Herniated disc
The intervertebral disc is composed of an annulus fibrosus of cabbageágene that has an núpulpy cleo with a gelatinous consistency. When a rupture of the mentioned ring occurs, this material of theúcleo can you get out, giving theí origin of what is known as herniated disc.
The annulus fibrosus is surrounded by different nerve endings., and when the fibers of the ring and núcleo comes into contact with the ends irritates them, provoking theí cause low back pain, and if what gets irritated are the raínervous stop, what to sufferá to beá a ciática. Sayún daysínerve z affected varyán the sísymptoms to sufferánot on the leg.
Spondylolisthesis
A spondylolisthesis is the displacement of a vévertebra on another. This is what is called spinal instability.. When there is excess movement in the vévertebra causes low back pain, when moving the vévertebra the caliber of the lumbar canal is reduced, giving theí origin of compressionón of its neurol structuresógicas and causing a ciática.
spinal fracture
when a vébroken vertebra can cause lower back pain. On some occasions it can happen that one of the fragments of the vévertebra can get to compress a raíz nervous and provoke aceí a ciática.
Tumors
A fourth cause of lumbociática is the disease of a tumor, that when it grows weakens the vértebra, can lead to a spinal fracture. Además, the growing tumor can compress the neuronal structuresócool, and that's when the ciática.
Diagnóstico
For the diagnosis of a lumbociática resorts to the use of:
- Radiographerías. A través of a radiographía The presence of a fracture can be assessed, además to be able to observe the existence of some instability, el grado de degenerationón vertebral and sometimes even tumors can be diagnosed.
- TAC. A través of the CT can assess the different structures óseas con máwith definitionón that in an x-rayía, además to be able to assess if there are herniated discs and know the diámedullary canal meter. CT is considered the best test with which to determine if you have vertebral fractures.
- magn resonanceética. The magn resonanceética It is the best test to be able to make an assessment.ón the medullary canal and herniated discs. A través of the MRI it is possible to verify the presence of tumors as wellí like the valuationón of fractures that when they are mild can go unnoticed on radiographsías.
Treatment of lumbociática
When carrying out the treatment of lumbociática It is important to distinguish between two types of treatment:
Conservative treatments
Among the conservative treatments lumbociática we find the following:
- Doctorsón. East á indicated for periods that do not exceed two weeks as wellí as in exacerbations of lumbociácriticalóunique. For this you can resort to the use of analgéphysical and anti-inflammatory, and it can even beíeven apply muscle relaxants.
- Physiotherapy. Linked to medicationón, it is common for physiotherapy treatments to be introduced, like the puncióNo dry or mesotherapy, among others.
- infiltrations: There are different types of injections that can be used to improve a lumbociática. You can resort to the use of facet blocks or carry out a curlólysis with which to carry out a treatment of low back pain, epidural infiltrations or foraminal infiltrations that help improve ciática.
surgical treatmentsúrgicos
There are an infinite number ofétechniques that can be used to treat a problem of lumbociática, opting for one or the other depending onón of the cause that originated it. Some of the options to whicháthey can be appealed:
- Nucleolisis. It consists of dehydrationón of the intervertebral disc, so that the pressure is reducedón that exerts on nerve endings. East á indicated for contained protrusions and hernias.
- spinal endoscopy. It's the técnica más advanced to treat the lumbociática, being able to treat those that originate from a herniated disc, for a canal stenosis or perform a fusión vertebral.
- Discectomía y laminectomía: it's técnics wantútraditional logics, leave witháthey are used to decompress the raínervous stop. These require an incisionón of 4-5 centímeters and to access the channel and cut músculus and part of the jointón facets.
- Hugón vertebral. In cases of spondylolisthesis, in which the degenerationóIf the disc is very advanced or to decompress the nervous structures, a lot of bone must be removed, a fusion must be associatedón vertebral a la discectomía o laminectomía. In this sense, there are different ways to carry out a fusionón vertebral, which depend on functionóno of the pathologyíwhat the patient suffers, así as by the surgeon's own experience.
