open access

Vol 77, No 2 (2018)
Case report
Submitted: 2017-05-26
Accepted: 2017-07-27
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.
Affiliations
  1. Spine Department and Deformities, Interbalkan European Medical Center, Thessaloniki, Greece.
  2. Laboratory of Forensic Sciences, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece.
  3. First Orthopaedic Department of 'Aristotle University of Thessaloniki', 'Papanikolaou' Hospital, Exohi, Thessaloniki, Greece.

open access

Vol 77, No 2 (2018)
CASE REPORTS
Submitted: 2017-05-26
Accepted: 2017-07-27
Published online: 2017-08-31

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)

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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Keywords

sacralisation, fusion, lumbar vertebra, coccyx, low back pain, coccygodynia

About this article
Title

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

Journal

Folia Morphologica

Issue

Vol 77, No 2 (2018)

Article type

Case report

Pages

397-399

Published online

2017-08-31

Page views

2186

Article views/downloads

1033

DOI

10.5603/FM.a2017.0081

Pubmed

28933804

Bibliographic record

Folia Morphol 2018;77(2):397-399.

Keywords

sacralisation
fusion
lumbar vertebra
coccyx
low back pain
coccygodynia

Authors

S. Kapetanakis
G. Gkasdaris
P. Pavlidis
P. Givissis

References (12)
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  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.
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  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.

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