What's up your spine?
Causes & Symptoms
When the vertebrae leave their position.
The vertebrae in your spine sit tightly between the intervertebral discs and are held in shape by ligaments, tendons and muscles. When the vertebrae slide, one or more vertebral bodies usually shift in the lumbar vertebra area. They become detached from their original position, slide forward, drift backwards or turn sideways. That in itself doesn't cause pain. The deep-seated back pain usually only arises when vertebrae rub against each other, intervertebral discs are squeezed or nerves are squeezed. This can lead to other diseases such as disc damage, herniated discs or osteochondrosis.
The vertebral sliding is divided into four degrees of severity:
- Grade I: shifted less than 25%
- Grade II: shifted 25 to 50%
- Grade III: 51 to 75% shifted
- Grade IV: shifted more than 75%
Causes: How do sliding vertebrae develop on the spine?
Vertebral slippage is either hereditary due to malformations in growing age or age-related due to signs of wear and tear on the spine. As you age, your spinal segments become more unstable. The individual vertebra is no longer held and can more easily slip out of the existing position.
In a few cases, vertebral slippage can also be triggered by overstraining the spine in competitive sports. Artistic gymnasts, pole vaulters and dolphin swimmers are at risk here. Serious injuries to the spine can also severely impair stability and cause the vertebrae to slip.
Sliding vertebrae: Symptoms are rarely seen.
More than half of those affected are symptom-free. Patients with congenital slipping of the vertebrae also rarely complain of back pain. Your vertebrae slide out of the natural shape of the spine so slowly that the surrounding nerves and intervertebral discs are seldom squeezed. Only in patients with vertebral sliding of more than 50 percent (grade III and IV) do we often observe severe back pain, especially after getting up. The pain usually increases in everyday life, for example when lifting and carrying heavy loads. The mobility of the (lumbar) spine can decrease.
If a vertebra slips so much that a nerve root is pinched, numbness often occurs in the arms or legs. Loss of control of bladder and rectal function and sexual disorders are also possible. In the event of paralysis or dysfunction, please consult a doctor immediately.
Diagnostics: This is how vertebral sliding is determined.
Since vertebral slippage can affect different regions of the spine, we tailor our diagnostics to your individual needs. In the Schön Klinik, we first check possible abnormalities in an initial consultation that corroborate the first suspicion of vertebral slippage. This can be an increased hollow back, but also tactile pain and hardening of the back muscles. In pronounced cases, a step formation between the spinous processes can be felt. In addition, weakness in hip flexion, knee extension or when raising and lowering the foot can be possible. Parasitic sensations in the thigh or lower leg area can also occur.
If the suspicion of slipping vertebrae could not be ruled out, modern imaging methods such as X-rays and magnetic resonance tomography (MRT) follow the physical examination for careful diagnosis.
Various procedures provide security.
With the help of an X-ray examination, one can usually reliably detect a slipping of the vertebrae and other changes in the spine. However, we strongly recommend magnetic resonance imaging (MRI) for an exact clarification. With the help of MRI, intervertebral discs, nerve roots, tendons and ligaments can be visualized. The suspicion of a narrowed nerve canal or pinched nerves can be clearly substantiated or refuted. Joint cysts or herniated discs are also shown in the slice images.
Alternatively, an X-ray with the administration of contrast media (myelography) or a computed tomography with the administration of contrast media (CT myelography) can be taken.
If neurological abnormalities such as sensory disturbances and paralysis appear, we also recommend a neurological examination: In electromyography (EMG), we determine the nerve conduction speed with the help of glued-on electrodes.
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