Instability of the lumbosacral spine
A.N. LIKHOLETOV1, 2, V.YU. CHERNETSKII1, 2
1M. Gorky Donetsk National Medical University, Donetsk, DPR
2Republic Traumatology Center, Donetsk, DPR
Contact details:
Likholetov A.N. — PhD (medicine), Associate Professor of the Department of Traumatology, Orthopedics and Emergency Surgery
Address: 16 Ilyich Ave., Donetsk, Donetsk People’s Republic, 283003, tel.: +7-949-007-77-71, e-mail: likholetov-an@rambler.ru
The instability of the lumbosacral spine is determined by a disability to maintain the connections between vertebrae, to prevent their displacement depending on the load and physiological position of the body, which from the standpoint of biomechanics leads to a violation of the proper functioning of the spine. Depending on the violation of the constituent element of the vertebral-motor segment, there are three types of instability: discogenic, discartrogenic (retrolisthetic type) and discartroosteogenic (antelisthetic type). The clinical picture of spinal instability is characterized by a violation of the supporting function and the failure of the supporting complexes, the formation of spinal deformities, which causes irritation of the spinal cord and is accompanied by pain syndrome, muscle tension, movement restriction and neurological disorders. The clinical symptoms of instability in the lumbosacral spine include: the «tightrope walker» gait, with pronounced deformities accompanied by a «duck» gait; the «step» symptom; the «reins» symptom; increased pain syndrome during movements in the spine; an increase in lumbar lordosis; horizontal location of the sacrum; hypotrophy of the gluteal muscle. The main tools for diagnosing instability are functional radiographs, spiral computed tomography, magnetic resonance imaging and the use of the scoring method. Treatment of instability in the lumbosacral spine depends on the underlying disease. The main method of surgical treatment of instability in the spinal-motor segment is decompressive-stabilizing surgical interventions, taking into account the correction of the vertebral-pelvic relationships using modern interbody implants.
Key words: spinal instability, lumbosacral region, diagnosis, treatment.
(For citation: Likholetov A.N., Chernetskii V.Yu. Instability of the lumbosacral spine. Practical medicine. 2022. Vol. , № , P.)