LUMBOSACRAL TRANSITIONAL VERTEBRA ASSOCIATED WITH SACRAL SPINA BIFIDA OCCULTA: A CASE REPORT

Congenital malformations such as lumbosacral transitional vertebrae and spina bifida occulta constitute unrare anomalies and could affect the symptomatology of low back pain. A transitional vertebra is characterized by elongation of one or both transverse processes, leading to the appearance of a sacralized fifth lumbar vertebra or a lumbarized first sacral vertebra. Furthermore, sacral spina bifida occulta is a developmental anomaly that corresponds to the incomplete closure of the vertebral column. In the present case report, we describe a case of a dried sacrum presenting a partially sacralized fifth lumbar vertebra and total spina bifida, extended from first to fifth sacral vertebra. A pseudoarthrosis is formed on the left side and the specimen could be incorporated in Castellvi’s type IIa. Moreover, the incidence, morphology, clinical and surgical significance of these spinal malformations are discussed.

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Transverse sacralization of lumbar vertebrae: prevalence according to Castellvi classification

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20164835 ◽

2016 ◽

Vol 3 (1) ◽

pp. 116

Author(s):

Juhi V. Patel ◽

Chetan M. Mehta ◽

Nandakishore G. Patil ◽

Shreya R. Sehgal

Keyword(s):

Lumbar Vertebrae ◽

Lumbar Vertebra ◽

Transverse Process ◽

The Body ◽

Type I ◽

Transitional Vertebra ◽

Spinal Movement ◽

Vertebral Disc ◽

Fifth Lumbar Vertebra ◽

Lumbosacral Transitional Vertebra

Background: Sacralization of L5 is a congenital anomaly, in which the lumbar vertebra, mainly its transverse process, gets fused or semi-fused with the sacrum or the ilium or to both. This fusion can occur in one or both sides of the body. Sacralization leads to fusion of the L5 (fifth lumbar vertebra) and S1 (first sacral vertebra) and the inter-vertebral disc between them may be narrow. Sacralization of lumbar vertebra may be asymptomatic but is not always clinically insignificant. While sacralization may not affect at all, it can cause problems in some cases. Sacralization may be at times associated with problems in biomechanics and affect the ways of movement and posture control. Sacralization may also be an important consideration in disc surgeries. This study has been carried out to find out prevalence of sacralisation of transverse process of fifth lumbar vertebrae.Methods: The present study of transverse sacralisation of fifth lumbar vertebra was carried out on 35 randomly selected patients. The sample consisted of patients undergoing CT scan for abdominal complains. Bone window of all patients were evaluated to look for lumbosacral transitional vertebra.Results: The prevalence of transverse sacralization of lumbar vertebra turned out to be 25.7% out of which Castellvi type IIb was found to be most common, accounting for 33.3% cases. 5.7% comprised the group of normal variant (Castellvi’s type I) and 68.6% were normal. Conclusions: It is important to determine lumbosacral transitional vertebra as it can affect spinal movement and put excess stress on the lumbar vertebrae and in between disc. Moreover it can have a bearing on counting of vertebral levels specially during planning of spinal surgey.

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Giant cell tumor of the fifth lumbar vertebra with a three-year follow-up: case report and review of the literature

European Journal of Orthopaedic Surgery & Traumatology ◽

10.1007/s00590-012-0976-1 ◽

2012 ◽

Vol 22 (S1) ◽

pp. 15-19

Author(s):

Michael Athanassacopoulos ◽

Georgios K. Triantafyllopoulos ◽

Spyridon G. Pneumaticos

Keyword(s):

Case Report ◽

Giant Cell Tumor ◽

Giant Cell ◽

Lumbar Vertebra ◽

Cell Tumor ◽

Review Of The Literature ◽

Fifth Lumbar Vertebra

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An Adolescent Athlete with Low Back Pain Associated with Spina Bifida Occulta at the Thoracolumbar Junction : A Case Report

The Journal of Medical Investigation ◽

10.2152/jmi.66.199 ◽

2019 ◽

Vol 66 (1.2) ◽

pp. 199-200 ◽

Cited By ~ 1

Author(s):

Tsuyoshi Goto ◽

Toshinori Sakai ◽

Nori Sato ◽

Shinsuke Katoh ◽

Koichi Sairyo

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Case Report ◽

Spina Bifida ◽

Spina Bifida Occulta ◽

Thoracolumbar Junction ◽

Low Back ◽

Adolescent Athlete

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Sacralization of fifth lumbar vertebra – A case report

Journal of Anatomical Society of India ◽

10.1016/j.jasi.2015.07.237 ◽

2015 ◽

Vol 64 ◽

pp. S60-S61

Author(s):

S.H. Dakare ◽

P.S. Bhuiyan

Keyword(s):

Case Report ◽

Lumbar Vertebra ◽

Fifth Lumbar Vertebra

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An Unusual Variation in the Anatomy of Cadaveric Fifth Lumbar Vertebra with Mushroom Shaped Bony Mass - A Case Report of Partial Sacralisation and Literature Review

Journal of Research in Medical Education & Ethics ◽

10.5958/j.2231-671x.1.2.030 ◽

2011 ◽

Vol 1 (2) ◽

pp. 137

Author(s):

Anterpreet K Arora ◽

Poonam Verma ◽

Sonney Singh Kapoor ◽

J S Kullar ◽

Manisha Sharma

Keyword(s):

Case Report ◽

Literature Review ◽

Lumbar Vertebra ◽

Fifth Lumbar Vertebra ◽

Bony Mass

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Transitional Vertebra and Spina Bifida Occulta Related with Chronic Low Back Pain in a Young Patient

Cureus ◽

10.7759/cureus.837 ◽

2016 ◽

Cited By ~ 1

Author(s):

Maryam Kundi ◽

Maham Habib ◽

Sumbal Babar ◽

Asif K Kundi ◽

Salman Assad ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Spina Bifida ◽

Young Patient ◽

Chronic Low Back Pain ◽

Spina Bifida Occulta ◽

Low Back ◽

Transitional Vertebra

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Study of Spina Bifida Occulta Based on Age, Sex and Localization

ARS Medica Tomitana ◽

10.2478/arsm-2019-0020 ◽

2019 ◽

Vol 25 (3) ◽

pp. 95-99

Author(s):

Sipos Tamas-Csaba ◽

Denes Lorand ◽

Brinzaniuc Klara ◽

Sipos Remus Sebastian ◽

Raduly Gergo ◽

...

Keyword(s):

Spina Bifida ◽

Thoracolumbar Spine ◽

Spina Bifida Occulta ◽

Radiology Department ◽

Radiologic Diagnosis ◽

X Ray ◽

Spina Bifida Aperta ◽

Chest X Ray ◽

Incomplete Closure ◽

Age And Sex

Abstract Introduction: Spina bifida is a spine malformation that appears as an incomplete closure of the spine during development. Most frequently it involves lumbosacral vertebrae. There are two types of spina bifida: spina bifida aperta and spina bifida occulta. In most of the cases spina bifida occulta is asymptomatic, and it is identified by accident. Objectives: the aim of this study was to correlate localization of spina bifida occulta with age and sex of the patients. Materials and methods: Between July 2017 and January 2019 there have been 108 patients diagnosed with spina bifida occulta at the Radiology Department of Dora Medicals Tîrgu Mureș. The diagnoses were based on thoracolumbar spine x-ray, pelvic x-ray and chest x-ray studies requested by specialist physicians. Radiologic diagnosis was followed by data processing and statistical analysis. Results: In 81% of the cases the lesion was localized to vertebra S1, and in 15% to vertebra L5; we identified other five cases of rare localizations: C7- T1- T2, T1, T2, S2. This lesion was diagnosed most frequently at ages from 11 to 15 years (44.4%). Spina bifida localized to L5 was more frequent in males (11/16, 68.7%). Cases localized to S1 were more frequent in females (60/88, 68.1%). All spina bifida cases in females localized to vertebra L5 were diagnosed before 20 years of age. Conclusions: Our results partially correspond to those reported in other published studies.

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