Sacralization: Features and Dangers of a Rare Anomaly

The mysterious word "sacralization" conceals an unusual congenital anomaly.

It is expressed in the fact that the last, fifth lumbar vertebra partially or fully fuses with the sacrum in the lumbosacral spine.

As a result, the number of lumbar vertebrae decreases by one, and in the sacral region - increases, which leads to pain and excessive strain on the spine.

Anatomical features of the sacredization of

Such an anomaly can take many forms. If the vertebrae have transverse processes, it is likely that under the influence of bone pressure they will take the form of a butterfly or fan wing.

At the point where the vertebra meets the sacrum, these processes can be welded or jointed. In this case, the gap between the transitional vertebra and the sacrum can be narrowed or absent altogether.

The spinous process is shortened and rests against the sacrum, and sometimes it can merge with its scallop. All this changes the space for the exit of nerves: they either change, or turn into other openings, similar to those that have a sacrum.

If a joint arises between the transverse process and the sacrum, the transitional vertebra retains its mobility. And with unilateral or bilateral full soldering of the sacrum and appendage, this vertebra can not move.

According to some researchers, sacralization also can be considered the deep location of the fifth lumbar vertebra between the ileal bones of the , even if the transverse processes do not contact the sacrum bones.

However, this version is not supported by traditional medicine, although experts do not deny that this may cause pain syndrome.

Types of anomaly

The sacralization of l5 can be divided into two main types:

1. With the full( true) , the fifth lumbar vertebra fully fuses with the sacrum, and the transverse processes are articulated with the ilium. In this case, the intervertebral opening takes the form of a channel corresponding to the posterior and anterior sacrum orifices. True sacralization can also be one-sided: the transverse process forms an articulation with the ileum, and bilateral.
2. False is characterized by the presence of a normal spacing between the vertebra and sacrum, but the transverse processes considerably increase, which causes them to come into contact with the sacrum and can then be soldered and articulated with it. Incomplete sacralization is likewise classified as one- or two-sided.

Complete sacralization happens:

• complete - with absolute merger of the vertebrae L5 and S1;
• partial - when the vertebrae grow together with arches or processes, as a result of which they become less mobile;
• deep -L5 penetrates into the sacral area imperceptibly, i.e.without signs of adhesion( this type is distinguished only by some physicians).

The deep location of the vertebrae L5 between the iliac bones is also considered a false type of sacralization, or is considered as a variant of development of the bones of the spine.

In addition, a false sacralization is also called ossification, i.e.deposition of salts in ligaments.

In this case, there are pathological processes, including Bechterew's disease, otherwise called ankylosing spondylitis. With it, calcium is washed away from virtually all ligaments of the spine.

What caused the anomaly?

There is no exact answer to this question. Most likely, it is a congenital pathology, which is caused by impaired development of the fetus.

Fortunately, this anomaly is rare - the probability that the back pain is caused by sacralization is no more than 2%.

How does the disease manifest itself?

Typically, such an anomaly in a person begins in 20-25 years in the form of pains in the lumbar region.

In this case, unpleasant sensations are greatly enhanced if you carry weights, stand for a long time, move a lot and play sports associated with a heavy load on your back.

Pains can be of two types depending on the place of origin: lumbar and sciatic. Lumbar spine is most often caused by secondary metamorphosis of the transitional vertebra and joints.

They can also appear due to the pressure exerted by the transverse process on the sacrum, or squeezing the intervertebral disc. Sciatic pain or both types immediately arise due to the effect of an abnormality on the nerve.

Another cause of lumbosacral pain is spondyloarthrosis, which develops at the site of adhesion. In addition to this, there may be osteochondrosis in the area of ​​the intervertebral disc.

Acute pains are caused by injuries( falls on the legs, dislocations) and excessive strain on the spine. Often, when a person feels burning or numbness in his legs.

The pain may be less noticeable in the horizontal position and strengthened in the vertical position.

Another sign of pathology is the discomfort when going down the stairs, while the rise does not cause any inconvenience to the .It is also worth considering if the pain is felt when jumping and lowering on the heels with legs shifted.

At the age of 25 years, when a person starts working, the pathology can manifest itself in other ways:

• pain in the lower limbs and buttocks;
• decrease or loss of skin sensitivity in the waist and hips;
• occurrence of pain during palpation along the spine;
• limited circular movements in the lower back;
• low mobility of the spine.

However, all these pathologies are manifested only with a pronounced sacralization, i.e.when intervertebral discs are sown in the lumbar spine.

How to identify pathology?

To determine the pathology with a 100% probability is impossible, but there is a test that will help to assume its presence:

• stand up straight;
• bring together the heels, place the socks in the sides;
• try to reach out to the floor with your hands;
• if you can not reach the floor with your fingers, ask someone to measure the remaining distance.

Such testing allows approximately to determine anomaly in the absence of pain syndromes.

To accurately diagnose the sacralization of l5 and determine its type can only be using an X-ray.

Anomaly is characterized by:

• lack of intervertebral space in the picture - in its place can be seen bone tissue;
• weak visualization or absence of shadows of spinous processes of vertebrae L5 and S1.

Snapshot will help to determine the presence of an anomaly and to understand whether there is no opposite option for the development of bones - lumbarization( the appearance of the 6th lumbar vertebra).

Methods of therapeutic therapy

If the pains are uncommon and unreliable, then conservative treatment can be done, which includes:

• physical therapy;
• massage of the sacrum and lumbar region;
• physiotherapy procedures;
• electrophoresis( done with novocaine);
• use of orthopedic corset;
• ultrasound procedures;
• sanatorium treatment;
• paraffin applications;
• acupuncture;
• anti-inflammatory and analgesic medicines.

However, if the nerve endings are strongly clamped, which causes a lot of discomfort and pain, surgical intervention is strongly recommended.

In the operation, the fusion of vertebrae L5 and S1 is dissected, and instead of the intervertebral disc, a transplant is inserted.

Possible complications of

The most common pathology can cause the occurrence of osteochondrosis, spondyloarthrosis and spondylosis in the upper segments of the spine, which increases the pain syndrome.

However, in most cases it does not cause many problems and does not interfere with the normal functioning of the internal organs.

In general, sacralization is a rare phenomenon, and in some cases it does not cause any inconvenience. It is a congenital anomaly, but you can get rid of it in an operative way.