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a The width of the two sides of the lamina is narrow from the beginning of development, resulting in the failure of fusion with the adjacent lamina below, forming a wide fissure on the surface of the sacrum, as shown in b. c The left lamina narrows gradually with the development process, as shown in d
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Purpose
Spina bifida occulta (SBO) is one of the most common congenital spinal deformities. Although many studies have demonstrated the influence of lumbosacral dysplasia on low back pain (LBP) in young athletes, there have been few studies on SBO among young people in other occupations. The purpose of this study is to investigate the distribution...
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Background
Spondylolysis and undiagnosed mechanical low back pain (UMLBP) are the main causes of low back pain (LBP) in adolescent athletes. No studies have evaluated the difference in clinical and radiographic factors between these 2 conditions. Furthermore, it remains unclear which adolescent athletes with LBP should undergo advanced imaging exam...
Citations
... Friedreich's ataxia, which leads to impaired muscle coordination and movement, has a direct impact on spinal alignment. 20 The severity of scoliosis in spina bifida patients, as reported by Li et al., 21 is closely related to the level of the spinal lesion, with higher lesions presenting greater risks of developing scoliosis. Developmental issues, such as those seen in spina bifida affect the spine's structural integrity, leading to higher instances of scoliosis. ...
... George et al. [55] reported on LSTV with SSBO observed on a dry bone sacrum of a Caucasian ("White") male and highlighted the importance of awareness of this anomaly. Sharma et al. [56] observed a higher prevalence of the co-existence of SBO and LSTV in patients suffering from LBP. SBO is a more frequent anomaly observed in the lumbosacral region of the vertebral column, as noted by Li et al. [57], with a 61.49 % (93/148) incidence in their study, with observation at variable vertebral levels ranging from 89 % (83/93) at S1 to 2 % (2/93) observed between S1-S4. ...
... The prevalence of SBO varies from 1.2 to 50% in different study populations [3]. The most accurate estimate of occurrence rate is 17% of examined spines [4]. ...
... Ayrıca SBO, eksik vertebral ark nedeniyle uygun olmayan ağırlık dağılımına ve kasların bağlanma yerindeki farklılıklar nedeniyle mekanik bozulmaya yol açar. 36 Lumbosakral transizyonel vertebra yaygın bir doğuştan anomalidir. Bertolotti sendromu, LSTV nedeniyle ağrı yaşayan hastalara verilen klinik bir tanıdır ve Bertolotti ilk olarak bu ilişkiyi 1917 yılında tanımlamıştır. ...
ÖZET Sakroiliak eklem (SİE) vücudun en büyük aksiyel eklemi olup, bel ağrısı vakalarının %10-30’una
sebep olmaktadır. Biyomekanik karmaşık yapısı nedeniyle tanı ve tedavi sürecinde güçlükler yaşanabilmektedir.
Sakroiliak eklemin mekanik ağrılarında, vakalarının %88’i tekrarlayan mikrotravma ya da
akut travmadan kaynaklanmaktadır. Hastaların şikayetleri SİE çevresindeki lokalize ağrı veya hassasiyetten,
kasıklara ve hatta tüm alt ekstremiteye yayılan ağrıya kadar değişkenlik gösterebilir. Tanıda detaylı
bir anamnez ve fizik muayenede SİE’ye yönelik tanımlanmış provakatif ve hareket palpasyon
testleri uygulanır. Bunun yanında destekleyici görüntüleme ve diagnostik enjeksiyon yöntemleri kullanılmaktadır.
SİE ağrısının tedavisinde analjezikler, fizik tedavi, egzersizler ve manuel terapi ilk basamak
tedavilerdir. SİE enjeksiyonları hem tanısal hem de terapötik olarak, tanı ve tedavi algoritmasının bir parçasıdır.
Tüm terapötik seçenekler ağrıyı iyileştirmede başarısız olduğunda, cerrahi müdahale düşünülebilir.
Anahtar Kelimeler: Sakroiliak eklem; bel ağrısı
ABSTRACT: The sacroiliac joint (SIJ) is the largest axial joint of the body and causes 10-30% of low
back pain cases. Due to its biomechanical complexity, difficulties may be experienced in the diagnosis
and treatment process. In mechanical pains of the sacroiliac joint, 88% of cases are due to either repetitive
microtrauma or acute trauma. Patients’ complaints range from localized pain or tenderness around
the SIJ to pain radiating to the groin and even the entire lower extremity. In the diagnosis, provocative
and motion palpation tests defined for SIJ are applied in a detailed anamnesis and physical examination.
In addition, supportive imaging and diagnostic injection methods are used. In the treatment of SIJ pain,
the use of oral analgesics, physical therapy, exercise therapy and manual therapy are the first-line treatments.
SIJ injections can be considered as part of the early diagnosis and treatment algorithm, both diagnostically
and therapeutically. When all therapeutic options fail to improve pain, surgical intervention
may be considered.
Keywords: Sacroiliac joint; low back pain
... A análise deu-se por meio da orientação dos processos articulares e encaixe das vértebras a cada nível intervertebral: Cervical (C), Torácica (T), Lombar (L), Sacral (S) e Coccígea (CO) (FIGURAS 1, 2 e 3). A avaliação foi realizada a partir da morfologia da fusão das lâminas do processo espinhoso, o qual resulta o ponto mediano do arco neural(LI et al., 2021;MA et al., 2018). ...
A espinha bífida oculta consiste em uma malformação congênita no desenvolvimento intrauterino, ocasionada por falha no fechamento dos arcos vertebrais posteriores e pode fornecer informações valiosas para a identificação humana. O objetivo dessa pesquisa foi avaliar a ocorrência de espinha bífida oculta em esqueletos humanos de ambos os sexos, pertencentes a uma coleção osteológica do nordeste brasileiro, verificando sua frequência, a região da coluna vertebral mais acometida e seu potencial individualizador. Trata-se de um estudo quantitativo cujo universo foi composto por 427 esqueletos pertencentes ao acervo do Centro de Estudos em Antropologia Forense da Faculdade de Odontologia de Pernambuco/Universidade de Pernambuco (CEAF/FOP/UPE). A amostra foi do tipo não probabilística e selecionada a partir dos critérios de inclusão e exclusão. Foi realizado o estudo macromorfoscópico minucioso das regiões da coluna vertebral dos esqueletos nas quais podem ser encontradas a malformação em estudo. A análise dos resultados foi obtida através de testes estatísticos, utilizando-se o programa IBM™ SPSS® (versão 20.0). A amostra final consistiu em 375 esqueletos, tendo sido observada uma frequência de 31,1% de espinha bífida oculta nesta coleção osteológica, com maior preferência para o sexo masculino. Apesar de acometer várias regiões da coluna vertebral, houve uma presença significantemente maior em vértebras no segmento sacral. Os conhecimentos anatômicos e osteológicos são indispensáveis para análises de características esqueléticas discretas. Tornam-se importante estudos científicos que permitam fornecer informações de diferentes populações, principalmente no tocante às características potencialmente individualizadoras, no contexto da identificação humana.
... Lumbar radiographs were retrospectively studied on 148 young people (with a median age of 23 years) with lower back pain, Li et al. found 17 cases (11.49%) with LSTV. Out of these, 8 patients also had SBO (8/17, 47%) [14] . In another review of pelvic radiographs of 64 patients with lower back pain along with LSTV, Sharma et al. found 27 (42.18%) ...
Common and minor birth defects, such as spina bifida occulta (SBO) and lumbosacral transitional vertebra (LSTV), are largely asymptomatic and overlooked. However, it is important for clinicians to consider their potential impacts on spinal stability. Neuromuscular scoliosis (NMS) is an abnormal lateral curvature of the spine that affects children with pre-existing neuromuscular conditions that are often complex to manage. The purpose of this case report is to describe the association of dual lumbosacral anomalies with complicated NMS. A 12-year-old boy was brought to the chiropractor by his mother for a consultation and possible care for the boy's back pain, progressive scoliosis, and long-standing walking abnormality that worsened quickly in the past 12 months. His mother stated that the patient walked on the balls of his left foot instead of putting weight on the heel ever since he started learning to walk. He had visited several pediatricians and neurologists since childhood. No one had been able to solve his problems. Radiographs showed right thoracolumbar curve of Cobb angle 20 °, left pelvic obliquity, a cleft in the L5 and S1, and articulation of the transverse processes of L5 with the bilateral sacral alae. The patient was diagnosed with NMS and functional leg length discrepancy attributed to SBO and a LSTV at L5 level. Multimodal chiropractic care and foot orthotics were used. After 18 months of interventions, normal spinal curve, heel-to-toe gait, and posture balance were retrieved successfully. To date, few reports have been published on the impacts of SBO along with LSTV upon the lumbosacral spine. This article will allow a better understanding of the potential impacts of these birth defects and considerable consequences they would have on the growing spine and, therefore, may help to alleviate their impacts.
... In the present study, SB was found to be present in 11.1% sacra which was comparable to the finding of Ali S et al in Pakistani population [23]. The frequency of occurrence of spina bifida varies widely ranging from 4.5% in British Population to 61.5% in Chinese population (Table 8) [24][25][26][27][28][29][30]. The most common vertebral level of SB was found to be at S1 (75% of SB cases) in our study which is similar to other investigators [9,16]. ...
Introduction: The sacrum is considered as a highly variable bone. Several morphological variations have been documented which exhibit differences in the frequency of occurrence and morphological characteristics in various study populations. Variant anatomy of the sacrum may be associated with backache, enuresis, neurological anomalies of the lower limb and functional disorders of lower urinary tract. Purpose: The purpose of this study was to identify and describe morphological variations of sacrum in Indian population and enable comparison with different populations. Materials and Methods: The study was conducted on 108 dry adult human sacra and morphological characteristics and variations were noted. Results: Sacral skewness was observed in 7.4% sacra with right sided skewness being predominant. The presence of accessory auricular surface (AAS) was noted in 13% sacra which was at the level of S3 vertebra in most sacra. Spina bifida (SB) was observed in 11.1% sacra and it was most commonly located at S1 vertebral level. Furthermore, the lumbo-sacral transitional vertebra (TV) was documented in 10.2% sacra. Conclusions: Sacrum displays numerous variations in Indian population such as skewness, AAS, SB and TV. Thorough knowledge of morphological characteristics and variations of sacrum is vital and should be contemplated during diagnosis and treatment of sacrum-related diseases. KEY WORDS: Accessory auricular surface, Spina bifida, Transitional vertebra, Sacral skewness, Variations.
... Anteriormente la cirugía era considerada tratamiento de elección incluso de manera profiláctica, pero actualmente es controversial el beneficio de la misma en pacientes asintomáticos, siendo preferible una conducta conservadora con estrecho seguimiento urológico y neurológico considerando que la cirugía se acompaña de un alto índice de complicaciones permanentes y que la mayoría de los pacientes no presentarán déficit neurológico a lo largo de su vida (2). Entre las medidas de prevención se recomienda evitar el ejercicio físico extenuante, disminuir carga de columna lumbar y reeducación postural, tal como se indicó en el caso presentado (9). ...
El disrafismo espinal oculto incluye alteraciones en la fusión del tubo neural, en el que la lesión está cubierta por la epidermis, su incidencia estimada es de 0,5 a 5 casos por cada 1000 nacidos vivos. Los estigmas cutáneos pueden ser el único signo de la patología, los cuales pueden no ser muy evidentes. Reporte de caso de mujer de 36 años que acudió a consulta por cuadro de dolor lumbar de inicio insidioso, de 3 semanas de duración, que con el paso de los días se fue intensificando, irradia a miembros inferiores, cede parcialmente con analgésicos comunes y se acompaña de parestesias en ambos miembros. Se solicitó TAC y RMN que reveló anomalía anatómica sacrococcígea caracterizada por abertura de canal raquídeo, ausencia de cóccix, situación baja del cono medular, siringomielia e hiperintensidad a nivel del filum terminal sugestivo de lipoma. Se confirmó el diagnóstico de espina bífida oculta a nivel sacro, con lipoma del filum terminal, médula anclada con situación baja del cono medular y siringomielia asociada. Actualmente es controversial el beneficio cirugía profiláctica en pacientes asintomáticos, siendo preferible una conducta conservadora con estrecho seguimiento urológico y neurológico, entre las medidas de prevención se recomienda evitar el ejercicio físico extenuante, disminuir carga de columna lumbar y reeducación postural.
