Sacralization is irregularity of the spine, where the fifth vertebra is fused to the sacrum bone at the bottom of the spine. The fifth lumbar vertebra L5 may fuse fully or partially on either side of the sacrum, or on both sides. Sacralization is a congenital anomaly that occurs in the embryo.

Sacralization often has no symptoms. It’s sometimes is associated with lower back pain or problems with posture and movement. It’s also called lumbosacral transitional vertebrae or LSTV. These anomalies are observed at about 3.5 percent of people, and it is usually bilateral. It occurs during embryonic development, when the vertebrae begin to ossify, in about the eighth week.


Clinical Features:

  • Low Back pain
  • arthritis at the fusion site
  • disc degeneration
  • biomechanical difficulties in movement(limited ipsilateral flexion)
  • limits to range of motion
  • Decreased coordination and balance
  • Muscle spasm and fatigueness
  • Sciatica
  • Pyriformis syndrome
  • Leg length discrepancy
  • Pelvic tilt


  • X-ray
  • MRI


Treatment depends on the type and degree of sacralization and what symptoms. The aims of treatment are-

  1. To relief pain
  2. To increase  mobility
  3. To increase coordination and balance
  4. To prevent deformity and other secondary condition like Pyriformis syndrome

The treatment procedure includes-

  1. Drugs
  2. Physiotherapy treatment
  3. Surgery

This may include the standard treatments for lower back pain:

  • anti-inflammatory drugs
  • muscle relaxants
  • steroid injections

Physical therapy

2015 studyTrusted Source reports that the Alexander technique of muscle retraining helps with posture and neuromuscular coordination. The basic idea for the Alexander technique, according to the study, is to “reduce back pain by limiting muscle spasm, strengthening postural muscles, improving coordination and flexibility and decompressing.

Sacralization Physical therapy

Pilate’s method may be more effective in this area.

Sacralization-Physical therapy-2

Spinal mobilization is helpful to prevent joint stiffness

Balance and coordination exercise, neuro dynamic solution technique is needed to prevent neuropathy.

Sacralization-Physical therapy-3

Other treatments

There are a few studies of other promising treatments.

A local anesthetic combined with radiofrequency strips in the pain area is successful to  pain relief in one case. The authors recommend further research in this technique.

2015 studyTrusted Source reported on the use of electric denervation as a minimally invasive method for pain relief in the space between the 5th lumbar vertebra and the sacrum.


Only 43 cases of surgeryTrusted Source for sacralization problems have been reported in the medical literature. More studies are needed to better understand when surgery may be helpful.

Surgery may be recommended to correct specific disc or other abnormalities that result from the sacralization.

Sometime people don’t notice or unconscious about their problem. We know sacralization is not curable but manageable disease. So, if we are aware from the beginning and under proper treatment, we can prevent further complications and lead a normal daily life.

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