Sacralisation: A Predisposing Factor of Lumbosacral Degenerative Changes in Young Population

Abstract

Introduction: Low Back Pain (LBP) is a most common symptom affecting about 80% of the population in their lifetime and results from numerous causes but the role of sacralisation in causing LBP is still controversial. Sacralisation of L5 may leads to stress concentration, which accentuates the degenerative changes and also development of degenerative spondylolisthesis. Therefore, the following study was planned. Aim: To determine whether the presence of sacralisation at L5 level influences radiological findings of the degenerative changes and LBP in young population. Materials and Methods: Fifty patients of both sexes, aged between 20-40 years with chronic LBP were included in the study and all showed the presence of sacralisation. They were subjected to both radiography and MRI examination, after taking detailed clinical history. All patients were assessed for radiographic parameters of degenerative changes like anterior slippage of L4 on L5 (% slip), facet osteoarthritis (by Fujiwara’s criteria 1-4 grades) and disc degeneration (by Frymoyer’s criteria grades 1-5) of L4-L5. Results: Total 50 patients were observed out of which majority were between 30-34 years age group. Anterior slippage of L4 on L5 was observed among 66% (p=0.033), facet osteoarthritis (p=0.480) among 56% or disc degeneration (p=0.007) among 70% of the patients. Conclusion: The present study showed that sacralisation is a predisposing factor of lumbar degenerative changes in in significant number of young patients with LBP. Further studies with large population are required to clarify the role of sacralisation in influence of degenerative changes.

Keywords

• congenital vertebral anomaly
• disc degeneration
• osteoarthritis