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What is Lumbarization?
The human spine is composed of vertebrae namely,
cervical, thoracic, lumbar, sacral and the coccyx at the
lower end. There are 5 lumbar vertebrae and 5 fused
sacral vertebrae, which are based in the region of
middle and lower back and facilitate movement of that
part .

 Lumbarization of S1 or lumbarization of first sacral vertebra is
a condition in which the first sacral vertebra is not completely
attached to its fused sacral components but instead this first
sacral vertebra appears like the other lumbar vertebrae.
 It is also called as an extra vertebra, additional lumbar vertebra
or transitional vertebra. It occurs due to non-fusion of first and
second sacral segments.
 This lumbarized S1 vertebra may also have a disc like the other
lumbar segments or may have a disc space that remains
underdeveloped.



 This lumbarized S1 vertebra is not completely a fused sacral
segment nor does it become a normal lumbar segment.
 This makes it difficult to accommodate the additional vertebral
joint while performing daily tasks and may make this vertebra
more vulnerable to injury and joint irritation.
 With advancing age and activities, the lumbarized first sacral
vertebra can find it difficult to cope and may become an area
that triggers pain, discomfort or may remain prone to injury.
Signs and symptoms

 In some cases complaints like
1. Back pain
2. Inflammation
3. Swelling
4. Stiffness of back
5. Muscle spasms
6. Increased risk of injury
7. Inter-vertebral disc problems with radiculopathy.

 Sacralization of L5 or sacralisation of fifth lumbar
vertebra is a congenital anomaly, in which the
lumbar vertebra, mainly its transverse process, gets
fused or semi-fused with the sacrum or the ilium or
to both.
 This fusion can occur in one or both sides of the
body.
 Sacralization leads to fusion of the L5 (fifth lumbar
vertebra) and S1 (first sacral vertebra) and the inter-
vertebral disc between them may be narrow.
Sacralization


 Some may be asymptomatic.
 Patients with sacralization are more prone towards
back problems than those of lumbarization.*****
Signs and symptoms

 Due to the semi fused or bilaterally fused L5
vertebrae to S1, the first thing to get compromised is
mobility unlike lumbarization.
 All the efforts are upon L4 now which will not be
able to cope up with the stresses of load bearing like
L5.
 More wear and tear of intervertebral joints can take
place at L4-L5 and L5-S1 level due to reduced disc
space.
 Can lead to IVDP which may further require surgical
intervention.
Why

 Mainly X-Rays
 CT scan
 MRI
Diagnosis

 Medications
 Surgical
 Rehabilitaion
Treatment

 NSAIDS
 SMR
 Steroid injection for severe pain and discomfort
Medications

 Surgical excision surgeries are opted where the
symptoms are severe.
Surgery

 Electrical modalities
 Specific treatment
Rehabilitation

 Spinal traction
 IFT
 TENS
 U.S.THERAPY
 SWD
 LASER
 MWD
 Spinal corset
 Rest
Symptomatic treatment

 Exercise regimen
a. Muscle strengthening
b. Muscle stretching
c. Core strengthening exercises
 Manual therapy
Specific treatment





 Revision time
Any Questions ???


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Pp for lumbarization and sacralization by Dr Dhruv Taneja Assistant Professor

  • 1. What is Lumbarization? The human spine is composed of vertebrae namely, cervical, thoracic, lumbar, sacral and the coccyx at the lower end. There are 5 lumbar vertebrae and 5 fused sacral vertebrae, which are based in the region of middle and lower back and facilitate movement of that part .
  • 2.   Lumbarization of S1 or lumbarization of first sacral vertebra is a condition in which the first sacral vertebra is not completely attached to its fused sacral components but instead this first sacral vertebra appears like the other lumbar vertebrae.  It is also called as an extra vertebra, additional lumbar vertebra or transitional vertebra. It occurs due to non-fusion of first and second sacral segments.  This lumbarized S1 vertebra may also have a disc like the other lumbar segments or may have a disc space that remains underdeveloped.
  • 3.
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  • 5.   This lumbarized S1 vertebra is not completely a fused sacral segment nor does it become a normal lumbar segment.  This makes it difficult to accommodate the additional vertebral joint while performing daily tasks and may make this vertebra more vulnerable to injury and joint irritation.  With advancing age and activities, the lumbarized first sacral vertebra can find it difficult to cope and may become an area that triggers pain, discomfort or may remain prone to injury. Signs and symptoms
  • 6.   In some cases complaints like 1. Back pain 2. Inflammation 3. Swelling 4. Stiffness of back 5. Muscle spasms 6. Increased risk of injury 7. Inter-vertebral disc problems with radiculopathy.
  • 7.   Sacralization of L5 or sacralisation of fifth lumbar vertebra is a congenital anomaly, in which the lumbar vertebra, mainly its transverse process, gets fused or semi-fused with the sacrum or the ilium or to both.  This fusion can occur in one or both sides of the body.  Sacralization leads to fusion of the L5 (fifth lumbar vertebra) and S1 (first sacral vertebra) and the inter- vertebral disc between them may be narrow. Sacralization
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  • 9.   Some may be asymptomatic.  Patients with sacralization are more prone towards back problems than those of lumbarization.***** Signs and symptoms
  • 10.   Due to the semi fused or bilaterally fused L5 vertebrae to S1, the first thing to get compromised is mobility unlike lumbarization.  All the efforts are upon L4 now which will not be able to cope up with the stresses of load bearing like L5.  More wear and tear of intervertebral joints can take place at L4-L5 and L5-S1 level due to reduced disc space.  Can lead to IVDP which may further require surgical intervention. Why
  • 11.   Mainly X-Rays  CT scan  MRI Diagnosis
  • 12.   Medications  Surgical  Rehabilitaion Treatment
  • 13.   NSAIDS  SMR  Steroid injection for severe pain and discomfort Medications
  • 14.   Surgical excision surgeries are opted where the symptoms are severe. Surgery
  • 15.   Electrical modalities  Specific treatment Rehabilitation
  • 16.   Spinal traction  IFT  TENS  U.S.THERAPY  SWD  LASER  MWD  Spinal corset  Rest Symptomatic treatment
  • 17.   Exercise regimen a. Muscle strengthening b. Muscle stretching c. Core strengthening exercises  Manual therapy Specific treatment
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  • 22.   Revision time Any Questions ???
  • 23.