Lumbar dislocation: Causes, symptoms and treatment

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Dislocation of the vertebrae in the lower-back region. 

[caption id="attachment_3656" align="alignleft" width="200" caption="Men are at a higher risk of lumbar dislocation because of greater involvement in high-impact sports"]Men are at a higher risk of lumbar dislocation because of greater involvement in high-impact sports[/caption]

What is lumbar dislocation?

Let’s first understand what lumbar refers to: In layperson terms, the lumbar region is referred to as the ‘lower back’.
The lumbar spine consists of 5 disc-shaped bones, vertically stacked upon each other. These vertebrae are identified by numbers L1 to L5, and are separated by cartilage cushion pads known as interverterabl discs. These vertebrae are the largest among all the other vertebrae of the spine and support a majority of the body’s weight.

Due to a high impact trauma, one vertebra may shift its relative position over the adjacent one. This is known as dislocation.

  • Dislocations are commonly accompanied by a fracture of the vertebra.
  • In addition, damage to the spinal cord that runs within the spine and is normally protect by the spinal bones is also common. As such, if traumatic dislocations are suspected it is paramount that the activity of the patient is restricted.
  • Further, risk of nerve injury is high in these conditions.

Causes for lumbar dislocation

  • Trauma from high-impact contact sports, motor-vehicle accidents, falls, skiing and diving accidents, and injuries from blasts or falling objects are all usual causes of fracture-dislocations of the lumbar spine.
  • Men are at a higher risk because of greater involvement in high-impact sports. Degenerative disc disease or arthritis is also causes for this condition.

Symptoms of lumbar dislocation

  • The primary symptom is moderate to severe back pain that is made worse by movement.
  • Cardiovascular compromise may occur due to excessive blood loss.
  • There may also be diverse neurological signs and symptoms, including coma.
  • When the spinal cord is involved: numbness, tingling, weakness, or bowel and bladder dysfunction may occur.

Tests and diagnosis for lumbar dislocation

  • Imaging studies such as X-ray, MRI, or CT scan are required urgently to assess extent of spinal damage, if any.
  • A full neurological examination is also warranted.

Treatment for lumbar dislocation

The patient must be stabilised first as per emergency management. Restriction of spine movement to ensure there is no further injury to the spine.

Once the acute events are settled, the lumbar fracture-dislocation may be approached for treatment using operative treatment or non-operative treatment.

For mere dislocations, closed reduction using traction may be used in an attempt to re-align the vertebrae. However, if fracture also exists, then open surgical procedures are best. Wires, screws, rods, and/or plates are used during open reduction and internal fixation.

Prognosis for lumbar dislocation

Lumbar vertebra dislocations, that do not fully realign are associated with a high incidence of pain and stiffness. If fracture and neurological damage are ruled out, outcomes are favorable.

Neurological deficits, including paraplegia, are possible complications of lumbar spine injury.

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