acute lumbar sprain
Introduction
Introduction to acute lumbar sprain Acute lumbar sprain is an acute laceration caused by excessive stretching of soft tissue such as the waist muscles, fascia and ligaments due to external force. It often occurs when lifting heavy objects and the waist muscles are strongly contracted. Acute lumbar sprains can tear the tissue of the lumbosacral muscles, periosteum, fascia and ligaments. basic knowledge The proportion of illness: 0.12% Susceptible people: no specific population Mode of infection: non-infectious complication:
Cause
Cause of acute lumbar sprain
Waist sprain (30%):
Waist sprains are mostly caused by walking slip, jumping, flashing body, running, mostly caused by muscle ligaments. Acute lumbar sprains are soft tissues such as waist muscles, fascia, ligaments, etc., which are suddenly pulled by external force. The acute laceration caused often occurs when lifting heavy objects and strong contraction of the waist muscles. Tissues such as the attachment points of the lumbosacral muscles, periosteum, fascia, and ligaments can be torn.
Therefore, the damage is lighter.
Waist laceration (30%):
Waist contusion and laceration is a more serious injury, such as high climbing, lifting, lifting heavy objects, excessive force or posture, combined with improper adhesion of the lumbosacral muscles, periosteum, fascia and ligaments, etc. Causes damage and tearing of the muscle fascia, ligaments, intervertebral facets and joint capsules of the lower back.
Soft tissue damage (30%):
At the same time accompanied by tissue fluid exudation, spotted hemorrhage; the edge of the wound is not neat, the surrounding tissue is heavier; the wound is small and deep, sometimes the wounds left in the wound are visible; Straight line, neat edges, less damage to the surrounding tissue, more bleeding; tissue damage around the wound wounded by firearms, heavy pollution, the wound can be left in the chest wall tissue.
Prevention
Acute lumbar sprain prevention
The main reasons for preventing acute lumbar sprains are as follows:
1. It is necessary to publicize and educate employees, strictly abide by the operating procedures, be familiar with production techniques, prevent ruthlessness, eliminate and reduce the incidence of work-related injuries.
2. Improve labor conditions as much as possible, replace heavy physical labor with mechanical operations, and concentrate on labor, especially when collectively carrying heavy objects, under concerted command, work together and keep pace.
3, master the correct labor posture, such as sputum, when lifting heavy objects, try to let the chest, waist straight, hip and knee flexion, get up should be the main force of the lower limbs, stand still and then move, lift, lift heavy objects, Should take a half-squat, so that the object is as close to the body as possible,
4. Strengthen labor protection. When doing heavy physical labor such as squatting, lifting, moving, lifting, etc., use a belt to help stabilize the lumbar spine, enhance abdominal pressure, and enhance muscle work efficiency. If working in cold and humid environment, You should take a hot bath to remove cold and dampness, eliminate fatigue, and try to avoid bending over forcing posture for too long.
Complication
Acute lumbar sprain complication Complication
The disease is commonly associated with supraspinous ligament, interspinous ligament and iliac ligament injury. In severe cases, ligament tear or spinous process may be caused. Some patients may have inferior lumbar posterior synovial membrane, mainly manifested as post-injury lumbar. Immediately, unbearable severe pain occurs. All the psoas muscles are in a state of tension and stiffness. The disease generally does not cause nerve damage. Some particularly severe patients may have recessive spina bifida.
Symptom
Acute lumbar sprain symptoms Common symptoms Sprains, blood stasis, lumbar muscles, swelling, scoliosis, lumbar pain, dull pain, soreness and weakness
Immediately after the injury, the patient developed lumbar pain, which was persistently severe. The next day, due to local bleeding, swelling, and low back pain, some of them only slightly reversed the waist. There was no obvious pain at that time, but the lower back felt pain. The waist activity is limited, can not be straight, leaning, leaning, twisting difficulties, coughing, sneezing, can make the pain worse when urinating and defecating, often hold the waist with your hands when standing, use your hands to support the chair when sitting, to relieve pain .
Pain occurs immediately on one or both sides of the psoas muscle sprain; sometimes pain can occur after half an day or overnight, the waist activity is blocked, the pain is slightly light at rest, the pain is more active or coughing, local muscle tension during examination, tenderness and The traction pain is obvious, but there is no blood stasis (except for external impactors).
Examine
Examination of acute lumbar sprain
The auxiliary examination method for this disease is mainly X-ray examination.
1. For those with less damage, the X-ray film has no abnormal performance;
2, severely injured, X-ray performance of general ligament injury, no abnormal findings, or see the lumbar physiology of the anterior disappearance of the spine, the lateral lobes of the interspinous ligament rupture showed increased distance between the spinous processes or combined with spinous processes, facet fractures .
Diagnosis
Diagnosis and diagnosis of acute lumbar sprain
diagnosis:
The patient has a history of lifting heavy objects. Some patients complained of a clear sound. After the injury, the severe pain was severe and they could not move immediately. The light ones still worked, but the pain was aggravated after the break or the next day, and even could not get out of bed. See the patient's waist stiffness, lumbar lordosis disappeared, there may be scoliosis and sacral tendon tendon, and obvious tender points can be found in the injured area.
Differential diagnosis
(1) Lumbar muscle sprain: The lumbar muscle is the most powerful in each segment of the spine. Its main function is to maintain the posture of the body. When sitting or standing, the back and back muscles are constantly contracting to resist gravity on the head, spine and ribs. The pelvis not only controls the gravity conveyed by the body when flexing forward, but also restores the upright posture. Except for the lateral muscle group, the sacral spine muscle is most susceptible to injury and causes the most common site of the tibia attachment point. , followed by the attachment of the aponeurosis on the side of the spinous process or on the transverse process, while the tear in the middle of the abdomen is less common.
(2) Spinal ligament injury: the supraspinous ligament is a cord-like fibrous tissue attached to the spinous processes of the vertebrae. The surface is connected to the skin, maintaining the upright posture of the trunk, and restricting the excessive flexion of the spine. The supraspinous ligament of the lumbar spine Stronger, but in the waist 5 ~ ? 1 often lacks or is relatively weak, and the waist has a wide range of activities, it is also easy to cause damage,
(3) Interspinous ligament injury: the interspinous ligament is located between the adjacent two spinous processes, located in the deep part of the supraspinous ligament, the ventral side is connected with the ligamentum flavum, and the dorsal side is fused with the fascia and supraspinous ligament of the spinal muscle. Together, forming a strong constraint on the activity of the spine, the lumbar flexion and extension action separates and squeezes the spinous processes, and the fibers of the interspinous ligaments rub against each other, which can cause degeneration over a long period of time. On this basis, the external injury factor, the interspinous ligament can be Breaking or slackening,
(4) Lumbar facet joint disorder: There are three joints in each lumbar vertebrae, that is, two posterior synovial joints and one anterior disc joint, and the articular surfaces of the superior and inferior articular processes of the adjacent vertebral bodies are matched to form a facet joint, surrounded by a layer. Wrapped in a thin and strong joint capsule, it can engage in flexion and extension and rotational movement, and plays a role in stabilizing the spine and preventing vertebral body slip. When the waist suddenly bends forward and rotates to one side, the joint space can be enlarged. The synovial membrane enters the joint space, and the synovial membrane is embedded when the waist is straight, and acute low back pain occurs.
(5) lumbosacral joint injury: the upper body weight depends on the intervertebral disc and the small joint between the lumbosacral support in the lower part of the body. The lumbosacral part is the most weight-bearing part of the entire spine. When the spine is flexed, stretched and rotated, it plays a role. On the facet joints, the joints have joint capsules, ligaments connected to allow certain activities, but are stretched, torn and subluxated during overextension, leading to lumbosacral joint damage, and abnormalities of the lumbosacral region Structures such as recessive spina bifida, lumbar vertebrae degeneration are also predisposing factors.
