Interspinous ligament injury
Introduction
Introduction to interspinous ligament injury The interspinous ligament is a sacral tissue connecting the two spinous processes. It consists of three layers of fibers, and the fibers are arranged in a crosswise arrangement, which is prone to wear. These two ligaments are mainly to prevent excessive flexion of the spine, and often occur at the same time. Because there is no supraspinous ligament at the waist 5-1, and it is between the active lumbar vertebrae and the fixed atlas, the force is the greatest, so the chance of injury to the interspinous ligament is also the largest. basic knowledge The proportion of the disease: the prevalence rate of the middle-aged and elderly people over 50 years old is about 0.005%-0.008% Susceptible people: no special people Mode of infection: non-infectious Complications: interspinous ligament injury
Cause
Causes of interspinous ligament injury
Etiology and pathology of interspinous ligament injury: long-term burying the head and bending the worker, do not pay attention to changing the posture regularly; the spine is unstable due to injury, so that the spine and interspinous ligament are often in a state of tension and can produce small tears, bleeding and Exudation. If accompanied by degenerative changes, it is more vulnerable. This kind of inflammatory stimuli is distributed to the branches of the posterior branch of the lumbar nerve of the ligament, and low back pain can occur. In elderly patients, the ligaments may be calcified due to degeneration and necrosis. The connection between the supraspinous ligament and the spinous process can be dislodged from the spinous process due to degeneration and rupture. In addition, due to the violent spine and interspinous ligament rupture, the fixation is poor after the injury and more scars are formed, which is also the cause of chronic low back pain.
Prevention
Interspinous ligament injury prevention
The main clinical manifestations of the interspinous ligament injury have a significant history of trauma. After trauma, the back pain is felt. The pain and tenderness are located in the middle of the two spinous processes, and the pressure is increased by heavy pressure. After exertion and bending over, the pain can be aggravated, and the pain can be temporarily relieved after the rest. The pain of the local pain points of the slave is temporarily relieved, and the tenderness is as expected after the disappearance of the drug. Lumbar flexion is limited. After the pain point is closed, the lateral radiograph of the lumbar vertebrae can show a widening of the spinous process, and the ligament of the lumbar spine can be partially broken, completely broken, loosened or perforated. Although the lumbar interspinous ligament angiography has certain reference value, it can be up to 70% with normal lesions.
Clinical attention should be paid to: (1) simple interspinous ligament rupture, mainly seen in the lumbar 5 ~ 1 segment; (2) interspinous ligament injury sometimes combined with lumbar disc herniation.
Complication
Interspinous ligament injury complications Complications interspinous ligament injury
In daily life and work, the flexion and extension of the lower back often separates and squeezes the spinous processes, causing the various parts of the interspinous ligament to rub, pull and squeeze each other, which can cause degeneration. On this basis, once the traumatic factor is added, the ligament may be loosened, broken, perforated, causing damage to the interspinous ligament. And the supraspinous ligament is absent in the lumbosacral region. Therefore, when the knee is bent extremely, the interspinous ligament is more stressed. When the knee joint is bent, the pelvis is fixed in the supination position. The interspinous ligament is highly pulled, which is the reason why the interspinous ligament injury occurs in the lumbosacral region. In the interspinous ligament injury above the waist 4, especially the fracture, and more complicated with the supraspinous ligament.
Symptom
Symptoms of interspinous ligament injury Common symptoms When bending, back pain, spinous process, tenderness, lower extremity, radiation pain, ligament strain
Clinical manifestations of interspinous ligament injury: no history of trauma. Low back pain does not heal for a long time, which is obvious when bending over, but it can also cause pain when the over-extension is squeezed by the interspinous ligament. Some patients may have pain in the ankle or hip. During the examination, there was tenderness between the spinous processes or the spines at the injured ligament, but there was no redness. Sometimes the supracondylar ligament can slide over the spinous process. Interspinous ligament injury can be confirmed by B-mode ultrasound or MRI.
Examine
Examination of interspinous ligament injury
The interspinous ligament of the waist 1 to the waist 3 is divided into four parts: the front part, the middle part, the middle part and the middle part. The interspinous ligaments of the waist 4 to the waist 5 and the waist 5 to the squat 1 have only the front, middle and back parts, and the parts. Cross each other.
Diagnosis
Diagnosis and identification of interspinous ligament injury
diagnosis
The interspinous ligament of the waist 1 to the waist 3 is divided into four parts: the front part, the middle part, the middle part and the middle part. The interspinous ligaments of the waist 4 to the waist 5 and the waist 5 to the squat 1 have only the front, middle and back parts, and the parts. Cross each other.
Differential diagnosis
The interspinous ligament is located deeper between the adjacent two spinous processes, which is thin and weak and not as tough as the supraspinous ligament. The interspinous ligament with the posterior branch of the lumbar nerve, and the supraspinous ligament to limit the excessive flexion of the spine.
