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Partial Sacralization - Cause of Pain?

Cliff JumperCCliff Jumper Posts: 6
edited 06/11/2012 - 8:40 AM in Lower Back Pain

I have been undergoing almost constant back pain for close to three years now. I have been to three different doctors and had every kind of diagnostic they could think of. MRIs, CT, Mylograms, More MRIs, Diagnostic Injections, Nerve conduction, etc. The nerve conduction says my S1 is not happy with about 15-20% increase in response time, but they cannot find the source of irritation.

The symptoms are numbness in the left two little toes/bottom of foot (S1 hint) and significant lower back pain. It comes on extremely harsh if I sit for more than 15 minutes and I am stuck to a recliner. I can walk, stand, lay down or recline. No sitting or I will pay with 3-4 days of intense pain. I drive like a low-rider leaning way back and can only do this for 15-30 minute stretches.

While a few discs L4-5, L5-S1 are slightly dessicated, there is no significant bulging or injury to the discs.

One thing that the doctors have seen, but they seem to believe its not related... on the left side the transverse process that sticks out on the L5 is about three times bigger than the one on the right side. It actually makes contact with the sacrum, although it appears not to be fused.

Now, when I have a really sharp lower back pain, it feels like a screwdriver is being pushed into my back just on the left side of center about 2-3" below my belt line.

I lay over a big exercise ball, relax and sometimes lever my arms and legs to force a stretch on my back. If I do this, often a "POP" occurs. When the pop occurs, the pain goes from a 6-7 down to a dull 1-2 instantly. The pop is on the left side, not in the middle of my back.

I asked the doctors, they say "Oh yea, partial sacralization is not uncommon, and many people that have it do not experience pain." OK, I can buy that. But is it possible that the L5 is getting kinked sideways or otherwise pressuring the nerves when the sacrum and that bone are making contact? Can partial sacralization cause pain?

I am wondering, is it possible to remove the bone orthoscopically (or at least reduce the size to where it no longer contacts the sacrum)?

Anyone here familiar with this?

The only thing that has relieved the pain so far has been cortisone injection at the L5-S1 joints, but it only lasted a few months. I cannot drive, go to a restaurant and enjoy a meal, movies, sitting in business meetings, etc. I actually have a recliner in my office due to back pain.

Any help?


  • I'm sorry I don't have an answer. Your leg pain sounds familiar to me but I couldn't sit or walk. I was wondering is the pain on the top and inside of your leg or back running along the outside? And does t start in the back and go around groin to front or stay along back side? There is a dermatome chart you can look at to see what disc levels are causing your pain. I had a fusion L-2/3/4 and my leg pain w/numbness was/is from back, around to front of groin area to top of leg,inside more than outside down to toes. My husband has L-5/S-1 and his pain is back down back of leg and along outside of leg. Good luck with findind answers and relief. Keep going back for opinions until you get help.

  • Hi Kathy,

    Its pretty clear that its S1. It travels down the butt, back outside of the leg and to the heel, side, outer two little toes.

    What the Drs cannot figure out is why that nerve is getting irritated.

    I was wondering if anyone found the partial sacralization might lead to a source of irritation, either mechanical by creating an un-natural lever point between the L5 and S1, or chemical by irritants in the region that might exist due to the bones grating upon each other.

    Thanks for your concern. Sorry to hear both you and your husband are dealing with this. Fortunately, my wife has a healthy back.
  • Last Monday I went in for a micro-surgery to implant the Flexus (Globus Medical) Interspinous spacer between my L4 and L5 processes.

    Upon detailed examination of the MRI and X-Ray, the Dr concluded that the L4 disk had dessicated enough to cause mild collapse of that joint, leading to pressure on the L5 and S1 nerves at the L5/S1 joint.

    The surgery took about 2 hours including trimming bone spurs from the L4/5 and L5/S1 facets and nerve exits.

    Immediately, I knew the Dr. had hit the bulls-eye. When I stood up, my back was solid again, rather than the popping that was felt when I stood or moved around.

    Years ago I told my GP that my back felt unstable, now it does not.

    I was able to sit on a plane the day after surgery for almost two hours with no sciatica. Previously, sitting more than 10 minutes would become excruciating. When I sit, I do not feel like I am sitting on a nerve. Its taking me a while to get used to it again. When I first sit down, I am cautious, but after a while I realize the nerve is not going to get pinched, and I can relax.

    Its been 5 days and the wound/incision has healed nicely and the only negative symptoms so far are some stray pains/tingling which are normal. Its going to take some time for the nerves to get happy again after all of the abuse they have taken.
  • Hi, I have recently found out abt my sacralization issue. So, did you get it healed?? Which dr. did you visited?? Can u provide me the info if they are in Los Angeles.

    Thank you so much

  • Hi folks,

    First off, the problem was not actually found and fixed.

    The "Flexus" implant moved and is no longer providing the function it was intended to do. I am in the process of determining whether or not to undergo a surgery to remove it, or to install a retainer to keep it in position.

    In theory, it was supposed to be self-retentive, but it did not do that. It migrated backward and while it has reduced the motion of my L4/L5 joint, the joint still moves and I still get pain.

    The good news is that its more of a severe irritation and sciatica only when I sit/drive for extended periods. It used to be extreme pain whenever I sat and usually a 3-4 day burst of ongoing pain if I sat for more than 10 minutes.

    The original topic about sacralization might be a red-herring as three different doctors have communicated to me that this is not the cause of my pain. More likely, it leads to a change in the dynamics of my spine which lead to damage of another area.

    The L4/L5 joint is clearly suffering from disc degeneration, a lot of motion (slipping back/forth) and thus the facets are worn and spurred. This is likely the source of the pain.

    I am now considering removal of the Flexus and fusion of the L4/L5 but hoping this is not required. Another option is an artificial disc replacement, but this is pretty scary to think about.
  • My lateral process L5 is fusing to my sacrum on the left, and it has been excruciatingly painful to me for almost 2 years. I have been told by many people that auto fusion is a long and arguous process, taking up to 5 years to complete. It feels like a knife in that area with severe spasm of the muscles over the sacralization.

    My L5 facets are degenerative also, causing pain. My fusion is at L4-5, but wish I had L5-S1 fused as well. There was some discussion about doing that level on my initial visit with my surgeon, but he quickly dismissed that as an option. My pain doctor at the time thought we were doing that level...it was a mass of confusion at the time, and now I have much regret that I did not know enough to advocate for myself.

    I'm with you about having an ADR or another fusion now. Who wants to have another big procedure unless you have to.

    Good luck with nailing down the cause of your pain.


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