Two Cases of Singular Sacral S1 Butterfly Vertebra
Arturs Balodis1,2, Roberts Tumelkans3, Cenk Eraslan4
1Institute of Diagnostic Radiology, Pauls Stradins Clinical University Hospital, LV-1002 Riga, Latvia.
Diagnostics (Basel, Switzerland)
|November 13, 2025
Summary
Butterfly vertebrae are congenital vertebral anomalies that can cause chronic pain. Diagnosis relies on recognizing characteristic radiologic signs, with MRI being the preferred imaging method for accurate identification.
Area of Science:
- Spinal pathology
- Congenital vertebral anomalies
- Radiology
Background:
- Butterfly vertebra is an uncommon congenital vertebral anomaly.
- It results from a defect in vertebral body formation during embryogenesis.
- This condition is most common in the thoracic and lumbar spine, but can occur in the sacral region.
Purpose of the Study:
- To present two cases of isolated S1 butterfly vertebra.
- To highlight the diagnostic modalities for butterfly vertebrae.
- To emphasize the importance of recognizing this condition for accurate diagnosis.
Main Methods:
- Case study presentation.
- Diagnostic imaging including X-ray, computed tomography (CT), and magnetic resonance imaging (MRI).
Main Results:
- Two cases of isolated S1 butterfly vertebra were identified in adult males presenting with chronic lower back and sacral pain.
- Radiological imaging confirmed the butterfly vertebra morphology.
- The cases demonstrated the utility of X-ray, CT, and MRI in diagnosing this condition.
Conclusions:
- Butterfly vertebrae, even when isolated, can be associated with chronic pain.
- Characteristic radiologic signs are crucial for diagnosis and differentiation from other pathologies.
- MRI is the preferred imaging modality for evaluating butterfly vertebrae.
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