Is sacralization really a cause of low back pain?

Area of Science:

• Orthopedics
• Radiology
• Anatomy

Background:

• Sacralization, a congenital anomaly where the last lumbar vertebra fuses with the sacrum, is often suspected as a cause of low back pain.
• The precise relationship between sacralization and low back pain remains controversial in clinical practice and scientific literature.

Purpose of the Study:

• To investigate the association between sacralization and the presence of low back pain using plain radiography.
• To determine if sacralization is a significant risk factor for developing low back pain.

Main Methods:

• A comparative study analyzing 500 lumbosacral radiographs from patients with low back pain and 500 from a control group.
• Radiographs were assessed for sacralization using the Castellvi classification system, noting patient demographics and specific vertebral measurements.

Main Results:

• The incidence of sacralization was 21.2% in the low back pain group and 16.8% in the control group.
• No statistically significant difference in sacralization rates was observed between patients with low back pain and the control group (P = 0.09).
• Castellvi Type IA was the most frequent anatomical variant identified.

Conclusions:

• The study did not establish a statistically significant relationship between sacralization and low back pain.
• Further research is warranted to explore other potential contributing factors to low back pain and lumbosacral variations.