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The sacrum is a large, wedge-shaped bone at the base of the spine that connects the vertebral column to the pelvis and plays a key role in stability and load transfer.
The sacrum is a large, wedge-shaped bone at the base of the spine that connects the vertebral column to the pelvis and plays a key role in stability and load transfer.
The sacrum, also known by its Latin name Os sacrum, is a large, triangular bone located at the base of the vertebral column. It is formed by the fusion of five sacral vertebrae (S1–S5), a process that is typically completed between the ages of 18 and 30. The sacrum forms the posterior part of the pelvis and connects the spine to the two hip bones via the sacroiliac joints (SIJ).
The sacrum is situated below the fifth lumbar vertebra (L5) and above the coccyx (tailbone). Its key anatomical parts include:
The sacrum is firmly joined to the pelvis via the sacroiliac joints. These joints allow only minimal movement but are essential for transferring forces between the trunk and the lower limbs.
The sacrum fulfills several important functions in the human body:
A sacral fracture most commonly results from high-impact trauma such as falls or motor vehicle accidents. In elderly individuals, osteoporosis-related insufficiency fractures are common. Symptoms may include severe pain, numbness, and in serious cases, nerve damage leading to weakness or loss of bladder and bowel control.
SIJ syndrome refers to pain originating from the sacroiliac joint, often radiating into the lower back, buttocks, or legs. It is a frequent cause of low back pain and can be triggered by overuse, pregnancy, or inflammatory conditions.
Sacroiliitis is an inflammation of the sacroiliac joints and is often associated with rheumatic diseases such as ankylosing spondylitis (Bechterew disease). It causes chronic back pain and stiffness, particularly in the morning.
Pain in the region of the sacrum and coccyx, known as coccydynia, can be caused by falls onto the buttocks, prolonged sitting on hard surfaces, or childbirth.
The sacrum can be affected by primary bone tumors such as chordoma or by metastases from other cancers. These can weaken the bone and cause nerve-related pain.
Several diagnostic methods are used to evaluate the sacrum:
Treatment of sacral conditions depends on the underlying cause:
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