Congenital Absence of the Sacrum and Lumbar Vertebrae with Prosthetic Management

Abstract

Five cases (one previously reported) of congenital absence of the sacrum with associated anomalies are described. Prior to this report, three cases of absence of the spine below the twelfth thoracic vertebra had been recorded: one reported by Blumel and associates2, a girl with absence of the spine below the tenth thoracic vertebra reported by Friedel13, and a boy with absence of the spine below the eleventh thoracic vertebra reported by Sinclair and associates26. The two patients with complete absence of the lumbar vertebrae and the two with anomalous lumbar vertebrae in our series presented an identical clinical picture, corresponding to that described in the case presented by Sinclair and associates. Attempts26 at reconstruction of the lower extremities in these cases have not met with success. The prognosis for these patients is similar to that for patients with paraplegia. The patients described in this report have been fitted with bilateral Canadian hip-disarticulation prostheses and trained like patients with paraplegia. It is believed that some success has been achieved in their rehabilitation.