From Big Medical Encyclopedia

SACRALIZATION (Latin sacralis sacral) — congenital anomaly of lumbosacral department of a backbone in the form of full or partial merge of the last lumbar vertebra to a sacrum. On character patol. changes S. is opposite lumbalizations (see) also meets more often the last. Both types of anomalies combine under the name «transitional lumbosacral vertebra».

the Diagrammatic representation of lumbosacral department of a backbone at the main forms of a sacralization: and — a normal structure of lumbosacral department of a backbone, the intervertebral disk L4-5 it is located at the level of crests of ileal bones (it is given for comparison); — a bone bilateral sacralization (L4 is located over the level of crests of ileal bones, the body and cross shoots of Lv are completely merged with a sacrum); in — a right-hand bone sacralization (the right cross shoot and a part of a body of «a transitional vertebra» are merged with a sacrum, the left cross shoot forms a synchondrosis with a side mass of a sacrum, the rudimentary intervertebral disk is kept); — a bilateral cartilaginous sacralization (the body and cross shoots of «a .perekhodny vertebra» form a synchondrosis with a sacrum); d — a right-hand joint sacralization (the increased right cross shoot of L5 forms an abnormal joint with a side mass of a sacrum; the zone of an osteosclerosis is shaded); S — a sacrum; 1 — «a transitional vertebra»; 2 — cross shoots of «a transitional vertebra»; 3 — a synchondrosis between the increased cross shoot of «a transitional vertebra» and side mass of a sacrum; 4 — a rudimentary intervertebral disk, 5 — a joint crack of an abnormal joint; 6 — the kept intervertebral disk; level of crests of ileal bones is shown by a dashed line.

It is possible to distinguish S. and to distinguish it from lumbalization only with the help rentgenol. researches. As it is not always possible to count vertebrae on the roentgenogram, it is necessary to be guided by the anatomic educations, next to a sacrum. Normal the intervertebral disk LIV—V is located at the level of crests of ileal bones and is defined on the roentgenogram in a direct projection (fig., a). For obtaining such roentgenogram with the smallest projective distortions it is necessary to straighten a lumbar lordosis, bending legs of the patient in knee and hip joints and trying to obtain a dense prileganiye of a waist to a table.

There are various forms of the SACRALIZATION.

1. Bone bilateral (fig., b) or unilateral S. (fig., c), at to-rykh the increased cross shoots (both or one) merge with a side mass of a sacrum. At unilateral bone S. on other party there can be a cartilaginous union (synchondrosis) or a free cross shoot. The intervertebral disk is absent or has a rudimentary appearance. The bone union from both or even on the one hand completely excludes a possibility of movements in a L5 segment — S1; besides, at a bone forkhma of S. always zarashchena dugootrostchaty joints.

2. Cartilaginous bilateral (fig., d) or unilateral S., at to-rykh a massive cross shoot of L5 forms a synchondrosis with a side mass of a sacrum. The intervertebral disk is, as a rule, kept, but in a rudimentary look. The synchondrosis, especially bilateral, creates a full immovability in this segment.

3. Joint unilateral (fig., e) or bilateral S. when the increased cross shoot of L5 forms an abnormal joint (neoarthrosis) with a side mass of a sacrum. Dugootrostchaty joints and an intervertebral disk are always kept though height of a disk is less than norm. Radiological the neoarthrosis is characterized by osteosclerotic reorganization of the jointed bones, formation of the expressed closing plates on their adjacent surfaces. The functional research, as a rule, reveals mobility in a L5 segment — S1.

Unilateral cartilaginous and especially joint S. can be followed scoliosis (see) owing to a side wedge-shaped shape of a body Lv that can lead to static and dynamic insufficiency of all lumbar department of a backbone and more prematurity of dystrophic changes in intervertebral disks and vertebrae.

Wedge, picture The page is defined by its form. Bone and cartilaginous S., as a rule, clinically are not shown. Pains are usually connected with osteochondrosis and arthrosis of an abnormal joint; at a joint form C. — with growth of osteophytes at the edges of joint surfaces (see. Arthroses ) and protrusion or loss of an intervertebral disk.

The most frequent complication Pages are osteochondrosis (see), spondylarthrosis (see), spondylosis (see) in overlying lumbar segments of a backbone with development of a pain syndrome.

Treatment it is shown only at emergence of pains. The physical therapy, massage, a dignity are most effective. - hens. treatment.

Forecast depends on degree morfol. changes, and also timeliness and efficiency of treatment.

See also Backbone, pathology .

Bibliography: Dyachenko V. A. X-ray osteology, M., 1954; Kosins to and I am N. S. Disturbances of development of the bone and joint device, L., 1966; Maykova-Stroganov B.C. ifin-to e l sh t e y M. A. N of Kostya and joints in the x-ray image, the Trunk, L., 1952; Reynberg S.A. Radiodiagnosis of diseases of bones and joints, book 2, page 183, M., 1964; T and of e r I. L. and Dyachenko V. A. Radiodiagnosis of diseases of a backbone, page 29, M., 1971; T and of e r I. L. and M and z about I. S. Radiodiagnosis of shifts of lumbar vertebrae, M., 1979.

M. K. Klimova; P. L. Zharkov (rents.).