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      Lumbarisation of the First Sacral Vertebra a Rare Form of Lumbosacral Transitional Vertebra Translated title: Lumbarización de la Primera Vertebra Sacra: Rara Forma de Una Vertebra de Transición Lumbosacral

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          Abstract

          In the lumbosacral region, anatomical variations occur with changes in the number of sacral vertebra either by deletion of first sacral vertebra or by the union of fifth lumbar or first coccygeal vertebra with sacrum. Lumbasacral transitional vertebrae (LSTV) is the most common congenital anomalies of the lumbosacral region. It most commonly involves the fifth lumbar vertebra showing signs of fusion to the sacrum known as sacralisation or the first sacral vertebra shows signs of transition to a lumbar configuration commonly known as lumbarisation. Complete transition can result in numerical abnormalities of the lumbar and sacral vertebral segments. Lumbarisation of first sacral vertebra is seen with a very low incidence of 2%. Knowledge of presence of such vertebral variation will be helpful for the clinicians to diagnose and treat patients with low back pain. Although sacralisation of fifth lumbar vertebrae is most commonly seen when compared to lumbarisation of first sacral vertebrae, we report here a case of lumbarisation of first sacral vertebrae for its rarity among the LSTV and clinical implications.

          Translated abstract

          En la región lumbosacra, las variaciones anatómicas se basan en cambios en el número de las vértebras sacras, ya sea por ausencia de la primera vértebra sacra o por unión de la quinta lumbar o primera vértebra caudal con el sacro. Las vértebras de transición lumbasacra (VTLS) son las anomalías congénitas más frecuentes de la región lumbosacra. La VTLS más común se produce a nivel de la quinta vértebra lumbar, con signos de fusión al sacro, proceso conocido como sacralización; mientras que la primera vértebra sacra también puede mostrar signos de transición a una configuración lumbar. A esto último se lo denomina lumbarización. La transición completa puede provocar anomalías numéricas a nivel de los segmentos vertebrales lumbares y sacros. La lumbarización de la primera vértebra sacra se observa con una incidencia muy baja, de solo 2%. El conocimiento de la presencia de dicha variación vertebral será de utilidad para los médicos al momento de diagnosticar y tratar a los pacientes con dolor en la parte baja de la espalda. Aunque la sacralización de la quinta vértebra lumbar se produce más frecuentemente en comparación con la lumbarización de la primera vértebra sacra, se presenta aquí un caso de lumbarización de la primera vértebra sacra, rara entre las VTLS, y con implicaciones clínicas.

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          Hox genes specify vertebral types in the presomitic mesoderm.

          We show here that expression of Hoxa10 in the presomitic mesoderm is sufficient to confer a Hox group 10 patterning program to the somite, producing vertebrae without ribs, an effect not achieved when Hoxa10 is expressed in the somites. In addition, Hox group 11-dependent vertebral sacralization requires Hoxa11 expression in the presomitic mesoderm, while their caudal differentiation requires that Hoxa11 is expressed in the somites. Therefore, Hox gene patterning activity is different in the somites and presomitic mesoderm, the latter being very prominent for Hox gene-mediated patterning of the axial skeleton. This is further supported by our finding that inactivation of Gbx2, a homeobox-containing gene expressed in the presomitic mesoderm but not in the somites, produced Hox-like phenotypes in the axial skeleton without affecting Hox gene expression.
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            Langman's medical embryology

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              Anatomy for Surgeons: The Back and Limbs

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                ijmorphol
                International Journal of Morphology
                Int. J. Morphol.
                Sociedad Chilena de Anatomía (Temuco )
                0717-9502
                March 2015
                : 33
                : 1
                : 48-50
                Affiliations
                [1 ] ESIC Medical College and PGIMSR India
                Article
                S0717-95022015000100007
                10.4067/S0717-95022015000100007
                680824b4-7fa2-4b10-91f8-e94e8cd92f7b

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Chile

                Self URI (journal page): http://www.scielo.cl/scielo.php?script=sci_serial&pid=0717-9502&lng=en
                Categories
                ANATOMY & MORPHOLOGY

                Anatomy & Physiology
                Vertebrae,Sacrum,Sacralisation,Lumbarisation,Transitional vertebrae,Vértebras,Sacro,Sacralización,Lumbarización,Vértebras de transición

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