Comment - Extra lumbar vertebra

Yoga Discussion Structural Yoga Therapy
#1

COMMENTS - I have concern about the person with the extra lumbar vertebra. This is likely a condition called spondylolisthesis, where S-1 and the other sacral vertebrae do not fuse in utero, as they should. Thus, S-1 becomes an “extra” lumbar vertebra. People who have this spinal anomaly are at high risk for fracturing the facets and should be discouraged from any arching of the back. Gentle bridge may be ok, but the degree of arching allowed needs to be determined by an orthopedic surgeon. Interestingly, 20% of the Finnish ballet has this and after they receive extensive PT, they resume ballet with modified back positions. The consequences of hyperextending the back are increased instability of the spine, and, ultimately, the probability of a spinal fusion. It would be a shame if insufficient caution in yoga leads to this major surgery. Free advice is worth what it costs but I learned this lesson from my 10-year-old daughter.

K

#2

K ? I appreciate your experience with your daughter and resulting concern for others. However, I suspect your daughter?s problem was a misdiagnosis rather than spondylolisthesis. Your definition is incorrect. This condition is listed in Taber?s Cyclopedic Medical Dictionary as ?any forward slipping of one vertebrae on the other below it. Predisposing factors include spondylolysis (the breaking down of the vertebrae structure ? this is perhaps the correct term for your daughters condition), degeneration, elongated pars, elongated pedicles and birth defects in the spine as spina bifida.?

#3

Well, I am glad that you research thoroughly and I appreciate your following up. My sources are reliable: my daughter has been treated by Pierre D’Hemecourt, M.D. of the Sports Medicine Clinic at Children’s Hospital, Boston. She had an extensive PT program and wore a BOB (Boston Overlap Brace) to manage her spondylolisthesis. I try to be conscientious and responsible about health and illness information because I am a nurse (with a Master’s Degree in cardiovascular nursing). I could have actually described my daughter’s condition a bit more clearly: She does have spondylolisthesis, not as a result of degeneration, but as a result of the structural anomaly (the "extra lumbar vertebra) and when that L5-“L6” (S1) vertebra was displaced (by means of overly rigorous arching while learning the butterfly stroke. While learning these lessons during her experience, I heard PTs and MDs make many references to the “extra lumbar vertebra”. Naturally, the same description, when I read it in your Q & A, did remind me of the precautions my daughter must take, and the restrictions it has meant for her reluctant yoga practice. I would assume a yoga student appearing with the same situation should be cautioned against back arching. Hippocrates knew about ahimsa, too: “First, do no harm.”

Happy Trails, K

#4

I agree about avoiding back arching. Most good teachers are taught to work more from the hip extensors (that is to strengthen the hamstrings and gluteus maximus) rather than the lumbar erectors. In this manner the tendencies to overstretch the quadriceps and psoas will be avoided. Many methods to encourage backbending in which the lumbar is compressed due to overstretching the front of the upper thighs and pelvis. When there are structural anomalies such as this, the student is really best off in one on one not a class. I appreciate your concern as an educated mother and am glad to have this dialogue with you.