Vol 77, No 2 (2018)
Case report
Published online: 2017-08-31

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Concurrent lumbosacral and sacrococcygeal fusion: a rare aetiology of low back pain and coccygodynia?

S. Kapetanakis1, G. Gkasdaris1, P. Pavlidis2, P. Givissis3
Pubmed: 28933804
Folia Morphol 2018;77(2):397-399.

Abstract

Sacrum is a triangular bone placed in the base of the spine and formed by the synostosis of five sacral vertebrae (S1–S5). Its upper part is connected with the inferior surface of the body of L5 vertebra forming the lumbosacral joint, while its lower part is connected with the base of the coccyx forming the sacrococcygeal symphysis, an amphiarthrodial joint. The existence of four pairs of sacral fora­mina in both anterior and posterior surface of the sacrum is the most common anatomy. Nevertheless, supernumerary sacral foramina are possible to be created by the synostosis of lumbosacral joint or sacrococcygeal symphysis. We present a case of an osseous cadaveric specimen of the sacrum belonging to a 79-year-old Caucasian woman. A rare variation of the anatomy of the sacrum is reported; in which, the simultaneous fusion of the sacrum with both the L5 vertebra and the coccyx has created six pairs of sacral foramina. This variation should be taken into serious consideration, especially in the domain of radiology, neurosurgery, orthopaedics and spine surgery, because low back pain, coccygodynia and other neurological symptoms may emerge due to mechanical compression. (Folia Morphol 2018; 77, 2: 397–399)

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References

  1. Esses SI, Botsford DJ, Huler RJ, et al. Surgical anatomy of the sacrum. A guide for rational screw fixation. Spine (Phila Pa 1976). 1991; 16(6 Suppl): S283–S288.
  2. Lee JY, Gil YC, Shin KJ, et al. An Anatomical and Morphometric Study of the Coccyx Using Three-Dimensional Reconstruction. Anat Rec (Hoboken). 2016; 299(3): 307–312.
  3. Mahato NK. Pedicular anatomy of the first sacral segment in transitional variations of the lumbo-sacral junction. Spine (Phila Pa 1976). 2011; 36(18): E1187–E1192.
  4. Marwan YA, Al-Saeed OM, Esmaeel AA, et al. Computed tomography-based morphologic and morphometric features of the coccyx among Arab adults. Spine (Phila Pa 1976). 2014; 39(20): E1210–E1219.
  5. Matveeva N, Papazova M, Zhivadinovik J, et al. Morphologic characteristics of sacra associated with assimilation of the last lumbar vertebra. Folia Morphol. 2016; 75(2): 196–203.
  6. Milicić G, Krolo I, Vrdoljak J, et al. Using magnetic resonance imaging to identify the lumbosacral segment in children. Coll Antropol. 2006; 30(1): 55–58.
  7. Miller A, Routt M. Variations in Sacral Morphology and Implications for Iliosacral Screw Fixation. Am Acad Orthop Surg. 2012; 20(1): 8–16.
  8. Postacchini R, Trasimeni G, Ripani F, et al. Morphometric anatomical and CT study of the human adult sacroiliac region. Surg Radiol Anat. 2017; 39(1): 85–94.
  9. Tague RG. Fusion of coccyx to sacrum in humans: prevalence, correlates, and effect on pelvic size, with obstetrical and evolutionary implications. Am J Phys Anthropol. 2011; 145(3): 426–437.
  10. Woon JTK, Maigne JY, Perumal V, et al. Magnetic resonance imaging morphology and morphometry of the coccyx in coccydynia. Spine (Phila Pa 1976). 2013; 38(23): E1437–E1445.
  11. Woon JTK, Perumal V, Maigne JY, et al. CT morphology and morphometry of the normal adult coccyx. Eur Spine J. 2013; 22(4): 863–870.
  12. Yoon MG, Moon MS, Park BK, et al. Analysis of sacrococcygeal morphology in Koreans using computed tomography. Clin Orthop Surg. 2016; 8(4): 412–419.