Symptom >> Surgical >> General Surgery

Waist stiffness and lumbar lordosis disappeared

Introduction
Cause
Examine
Diagnosis

Introduction

Introduction In the examination of acute lumbar sprain, the patient's waist is stiff and the lumbar lordosis disappears. There may be scoliosis and tendon spasm. Significant tender points can be found at the site of injury. Acute lumbar sprain is an acute laceration caused by excessive stretching of soft tissues such as the waist muscles, fascia, and ligaments due to external force. It often occurs when lifting heavy objects and strengthening the waist muscles.

Cause

Cause

Causes of lumbar stiffness and loss of lumbar lordosis:

There are two main causes of this disease: lumbar soft tissue injury:

(1) Waist sprain: The waist sprain is caused by walking slip, jumping, flashing body and running, mostly caused by muscle ligaments, so the damage is lighter.

(2) Lumbar contusion: Lumbar contusion and laceration is a serious injury, such as high climbing, lifting, lifting heavy objects, excessive force or posture, combined with improper muscle muscle fascia, ligament , intervertebral facet joints and joint capsule damage and tear.

Examine

an examination

Related inspection

CT examination general radiography

First, the symptoms:

Immediately after the injury, the patient developed lumbar pain, which was persistently severe. The next day, he suffered from local bleeding, swelling, and low back pain. Some of them only slightly reversed the waist. There was no obvious pain at the time, but the lower back felt pain. . Waist activity is limited. Can not be straight, difficulty in leaning, leaning, twisting, coughing, sneezing, urination can make the pain worse. When standing, often hold the waist with your hands, and use your hands to support the chair when sitting, to relieve the pain.

Pain occurs immediately on one or both sides of the psoas muscle sprain; sometimes pain can occur after half an day or overnight, lumbar activity is blocked, pain is slightly light at rest, and pain is more active or coughing. Local muscle tension, tenderness and traction pain were evident during the examination, but there was no blood stasis (except for external impactors).

Second, the diagnosis:

The patient had a history of lifting heavy objects, and some patients complained of a crisp sound. After the injury, the severe pain is severe and can not be active immediately; the light can still work, but the pain is aggravated after the break or the next day, and even can not get out of bed. During the examination, the patient's waist was stiff and the lumbar lordosis disappeared. There may be scoliosis and sacral tendon. Significant tender points can be found at the site of injury.

Diagnosis

Differential diagnosis

Symptoms of waist stiffness and lumbar lordosis disappearing:

Thoracolumbar and lumbar lordosis disappeared: Imaging examination of acute lumbar sprains X-ray films mainly showed signs of vestibular disappearance and lateral curvature of the lower thoracic and lumbar spine, generally without other changes. Acute lumbar sprains are commonly known as flashing waists in the folk, and are more common in clinical practice, especially in manual laborers; those who occasionally participate in sports or labor without prior preparation for physical activity are more likely to occur. Sitting in the office all the year round.

The physiological anterior protrusion of the female lumbosacral sac is obvious: the physiological anterior protrusion of the female lumbosacral sac is obvious at the beginning Initial: Lower extremity swelling and fatigue are the most common early symptoms. The affected limb has only mild edema, especially when standing for a long time and sedentary. Female lumbosacral sacral anterior protrusion is obvious, and the left lower limb will have a menstrual period similar to "adolescent lymphedema." Ferri had 3 patients with long-standing left lower extremity edema, and the angiography proved to be caused by compression of the left iliac vein. In 1993, Sloame et al studied 215 elderly people and found that the lower extremity can be concave 3mm deep edema in 88 cases, the left side is 34.5%, the right side is 6.9%, and it is believed that the left lower extremity edema is likely to be right common iliac artery compression. Left common iliac vein and associated lymphatic vessels. Therefore, for lower extremity edema without other reasons, it should be possible to have this possibility. Female patients may have prolonged menstrual period and increased menstrual flow, as well as symptoms such as swelling of the lower extremities due to pelvic visceral congestion and increased venous pressure during menstruation.

Adolescent scoliosis: adolescent idiopathic scoliosis idiopathic scoliosis is relatively common, with a prevalence of 2% to 4% in adolescents in the 10-16 age group, with a small degree of scoliosis. In patients with scoliosis around 20°, the ratio of male to female is basically equal; in the crowd of scoliosis greater than 20°, female: male exceeds 5:1. The fact that women with scoliosis are more severe suggests that female scoliosis may be more progressive and that they need treatment more than boys.

Compensatory lumbar lordosis: The clinical manifestations of osteoarthritis are mainly hip pain. When the condition develops seriously, hip flexion adduction, compensatory lumbar lordosis, lower back pain, and even walking.