Dangare Mansee S, Gangwani Nikita, Tikhile Priya, Bhagwat Anushka P, Deshmukh Mitushi, Phansopkar Pratik
Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Mar 19;16(3):e56513. doi: 10.7759/cureus.56513. eCollection 2024 Mar.
Anterolisthesis is a condition where a vertebra in the spine slips forward relative to the vertebra below it. Anterolisthesis is often described in terms of the direction of the slippage and the affected vertebrae, such as L5-S1 anterolisthesis, which indicates the slippage occurring between the fifth lumbar vertebra (L5) and the sacral bone (S1). Anterolisthesis can result from various factors, trauma, or congenital abnormalities. The symptoms associated with anterolisthesis can include lower back pain, stiffness, muscle tightness, and neurological symptoms if the slippage compresses nearby nerves. The piriformis muscle, situated deep within the buttocks, plays a crucial role in this scenario, as its contraction or inflammation can exacerbate the compression of the sciatic nerve, intensifying the pain and discomfort experienced by the individual. Patients with L5-S1 anterolisthesis and bilateral piriformis syndrome commonly report challenges in daily activities involving hip movement, such as walking, sitting, or standing for prolonged periods of time. The combined effects of vertebral slippage and piriformis involvement contribute to altered gait patterns and may lead to difficulties in maintaining a stable and pain-free posture. Effective management often necessitates a comprehensive approach, encompassing physical therapy, pain management strategies, and, in severe cases, surgical intervention. We report a case of a 75-year-old male who complained of pain in his back radiating to both lower limbs with a history of slipping and falling in the bathroom one month prior, sustaining an injury to his back, and who visited the orthopedics department ofAcharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi, Wardha, where an investigation was done and an X-ray revealed L5-S1 anterolisthesis. Physiotherapy plays a crucial role in reducing pain, improving the range of motion and muscle strength, decreasing muscle tightness, and enhancing the quality of life. The goal of physiotherapeutic rehabilitation for L5-S1 anterolisthesis management is to optimize functional recovery, reduce pain, improve the range of motion and muscle strength, and improve the overall quality of life for individuals with this condition.
椎体前移是指脊柱中的一个椎体相对于其下方的椎体向前滑动的一种病症。椎体前移通常根据滑动方向和受影响的椎体来描述，例如L5-S1椎体前移，这表明滑动发生在第五腰椎（L5）和骶骨（S1）之间。椎体前移可能由多种因素引起，如创伤或先天性异常。与椎体前移相关的症状可能包括下背部疼痛、僵硬、肌肉紧张，如果滑动压迫附近神经，还会出现神经症状。梨状肌位于臀部深处，在这种情况下起着关键作用，因为它的收缩或炎症会加剧坐骨神经的压迫，加重患者的疼痛和不适。患有L5-S1椎体前移和双侧梨状肌综合征的患者通常报告在涉及髋关节运动的日常活动中存在困难，如长时间行走、坐着或站立。椎体滑动和梨状肌受累的综合影响导致步态模式改变，并可能导致难以保持稳定且无痛的姿势。有效的管理通常需要综合方法，包括物理治疗、疼痛管理策略，在严重情况下还需要手术干预。我们报告了一例75岁男性病例，他抱怨背部疼痛并放射至双下肢，有一个月前在浴室滑倒摔伤背部的病史，他前往位于沃德哈县萨万吉的阿查里亚·维诺巴·巴韦农村医院（AVBRH）骨科就诊，在那里进行了检查，X线显示为L5-S1椎体前移。物理治疗在减轻疼痛、改善活动范围和肌肉力量、减轻肌肉紧张以及提高生活质量方面起着关键作用。L5-S1椎体前移管理的物理治疗康复目标是优化功能恢复、减轻疼痛、改善活动范围和肌肉力量，并提高患有这种病症的个体的整体生活质量。
