S1 - S4 or L1 - L5- Difference??

[Jess Mason]

:3a:
Hello Everyone,

Can someone help me we have been told our daughter has SB affecting the S1 - S4 area but I have noticed you all talk about L1, L2 etc. What is the difference between L and S?

Thanks

[dahliafaolan]

Ok, anyone feel free to jump in and correct me if I'm wrong about this, but L refers to the lumbar vertebra which are in the lower back. But S refers to the sacral vertebra which, if I remember correctly, are the last four vertebra of a normal human spine (also known collectively as the tailbone).

[Mustang Sal]

Hi there

Dahlia is right - L refers to the lumbar vertebrae, which normally consist of 5 seperate vertebral segments. S refers to the sacrum, of which there are also usually 5 segements, but these are fused together. This is the part of the spine that joins the back of the pelvis. The tailbone (coccyx) is right at the bottom of all this.

I found a link with a diagram which probably explains it better than I can - check it out
http://www.backpain-guide.com/Chapter_Fig_folders/Ch05_Anatomy_Folder/Ch5_Images/05-4_Overall_Spine.jpg

There's is loads of info in the internet about spines and stuff (probably too much) so why not have a little dig around, see what you can find? I'm sure others will come along and recommend some good sites that explain things in plain English, as some of them can be a be medical-jargonesque.

[LisaJoy]

The difference between S and L for spina bifida is significant because the nerve damage is at or below the level of the lesion, so the lower the lesion the fewer "systems" are involved in the nerve damage. So a sacral level lesion almost always will affect bladder and bowel, and often feet and ankles as well. The higher the level of the defect on the spine, the higher up the legs the nerve involvement. Bladder & bowel are almost always affected to some degree.

But we all know that nerve damage with sb can be really odd, so you might find someone with an "L" lesion who can walk and someone with an "S" lesion who is more impaired. No two cases are exactly alike -- which is why predicting outcomes before birth is so chancey.

[LisaJoy]

:3a:
Hello Everyone,

Can someone help me we have been told our daughter has SB affecting the S1 - S4 area but I have noticed you all talk about L1, L2 etc. What is the difference between L and S?

Thanks

Just to make myself clear, a diagnosis of a sacral lesion is generally good news, although it is impossible to predict exactly what impairments your daughter will have.

[angel]

Exactly my son has SBO but he also has Sacral Agenesis and i was told when he was born when the sacrum is affected the bowel and bladder problems are almost always unavoidable. we don't have just one level of the sacrum affected neither my son nor i have any sacrum at all

Angel

[ollieholmes]

Just out of interest whats the highest up the back it can get? Surely if its very high it will affect breathing etc.

[LisaJoy]

SB can occur as high as the cervical level, but it is rare. But it is also my understanding that C-level sb tends to be milder and have less nerve involvement. I've never really understood this.

"In general the level of the defect is related to the level of involvement. So an individual with an L2 (the lower back) lesion will have a less muscle weakness and paralysis than someone with a T8 lesion. The exception to this is children born with cervical spina bifida, which is the highest level of the spina column. These children rarely have paralysis."
http://www.waisman.wisc.edu/~Rowley/sb-kids/wbwsb.html

[ollieholmes]

Interesting. I thought that you couldnt get much higher than my partners lesion which is at T6.

[rachiebaby]

I was told I'm L-5 S-1 which would be the 1st sacral on the 5th lumbar does that make sense?

[Dodger67]

Yes 5th lumbar to 1st sacral makes perfect sense.
Mine is L1-2, which is a bit higher than yours.

[Jess Mason]

Thank you all for info - very helpful. Will def check that website out.

[Spiffynikki]

I keep reading things here about various lesions and am curious... most seem to be involving one or two vertabrae (sp?)... DD's lesion is from T12-L4... is this a very large lesion for spina bifida? Is that why docs and therapists are always suprised at her level of mobility?

[LisaJoy]

Yes, that's a large lesion -- probably explains their surprise.

[janjanwhit]

I have just found out my sons is L3 to L5. The doctors are very pessimistic but I am not. He has very good strength in his legs and supports his weight when you put his feet on the ground. He has no movement in his toes but good tone to the ankles. Although one clubbed foot. He is seven weeks old. I cant help but think that he sounds as though he will walk, at least as a child. Am i being to hopeful?

[angel]

I have just found out my sons is L3 to L5. The doctors are very pessimistic but I am not. He has very good strength in his legs and supports his weight when you put his feet on the ground. He has no movement in his toes but good tone to the ankles. Although one clubbed foot. He is seven weeks old. I cant help but think that he sounds as though he will walk, at least as a child. Am i being to hopeful?

Hi Jan,

He sounds a lot like me. I am level L4/L5 and although i have no tone in my lower legs (below the knee gets real thin) I can feel and move until you reach my ankles. Ankles and feet are the only paralysis i have. I also had one clubbed foot (my left) which was corrected with surgery when i was in first grade.
You are never to hopeful. If he can that is great if he can't without crutches I have no doubt that he will adapt just fine.
My son has SBO and although he can move everything i was told he wouldn't walk when he was a baby. They said he didin't have the muscles in his butt that he would need to propel him forward. He has No muscles it seems in his bottom it is just unusually flat so much so it alarmed the nurse when he was in the hospital after birth. Anyway I wanted to get him to use whatever he did have as much as any other baby would on the off chance they might be wrong. We put him in his walker (the baby walkers with the tray you can put toys on) I know he was to young when we first tried it cause his little feet didn't touch the ground. Eventually they did and he started pushing backward. He went everywhere backward for weeks but one day he got the idea of how to go forward and HE DID! I didn't know if that would mean he would walk or not cause this thing had wheels but he was propelling himself forward so i had hope. At 13 months my best friend called me at work (she babysat him) he took his first steps!! I was SO EXCITED! From that day on he has been walking. He can't run, he can't keep up with the other kids when they run, so the muscles do limit him a bit. There is nothing wrong with hope.

Angel

[elisaacd]

My son has SBO S2-5. He has bladder/bowel issues and has just started to lose feeling in his feet. He will have his 3rd surgery at the end of this month. I guess with each person it is different though.

[angel]

Each person is different. That is the only consistancy with SB. I don't know what level you would call my son. He only has 3 normal vertibra from his neck all the way down to having no sacrum at all. Level S1-S5 never formed at all. They call that sacral agenesis. i also have SA and SB myleo L4/L5.
My son's "holes" are from the chest view on an x ray there is a space in each one of them where they didn't completly close. Only 3 are formed completly. He has had 2 surgeries one tethered cord and one spinal fusion. He has full movement in his whole body with the exception of his toes. Two on the left foot he can't move very well at all and he can't spread his toes apart like one without any problems would. he has the bladder and bowel problems but we are doing well in that area with years and years of hard work. I have been told on other boards that it doesn't count if they have SBO it isn't the same. I have always said it is the same SB is SB no matter how many or how few problems it causes.

Angel

[Monique]

Keep in mind...I don't think it is always wise to completely "buy into" a doctor's prognosis. When I was born in 1974, the doctors told my parents that I would not live into adulthood probably, and even if I did, I would never walk. Well, I will be 35 next month and I am ambulatory.