Osseous Growth and Sacralisation in Sacrum - A Case Report

Abstract

BACKGROUNDA very common congenital anomaly called lumbosacral transitional vertebrae is seen in sacrum, which includes sacralisation and lumbralisation. Sacralisation is characterised by presence of partial or complete fusion of fifth lumbar vertebra with first sacral vertebra. During regular teaching of undergraduates, one sacrum was noticed with significant variation having large osseous growth on pelvic surface along with sacralisation of fifth lumbar vertebra. An osseous growth was extending on pelvic surface from right side of fourth lumbar vertebral body to body of sacralised fifth lumbar vertebra. Sacralisation of fifth lumbar vertebra along with fixation of fourth vertebra because of osseous growth can be the cause of early age back pain in an individual due to shift of seat of spinal movement to third lumbar vertebra above. Misexpression of HOX genes during intrauterine life is considered as cause of it. Such kind of sacral variation altogether can lead to delayed and difficult delivery of baby in female due to change in pelvic dimension and its biomechanics. Neurovascular and visceral compression manifestation can be a chief complaint of an individual with such variation in sacrum. Neurosurgeons and anaesthetist need to be alert regarding such possible variation to prevent faulty spinal surgery and spinal anaesthesia respectively.