Effect of Structural Physiotherapy Protocol on Pain and Radiological Changes by Computerized Vision in Sacralization: A Case Report

Abstract

A congenital disorder known as sacralization occurs when the fifth lumbar vertebra (L5) partially or totally fuses to the sacrum. Some cases might be asymptomatic but common indicators include stiffness, reduced mobility, and lower back pain. Purpose of this study is to evaluate the effect of structural physiotherapy protocol on pain and radiological changes by computerized vision in sacralization. The impact of a structured physiotherapy protocol was assessed using a single-subject case report design in a patient with sacralization of the lumbar vertebra. Ethical approval was obtained from both the institution and the parents. The intervention was carried out over a period of three months after a clinical examination and baseline radiological imaging. The Numerical Pain Rating Scale (NPRS) was used to measure the intensity of the patient's pain, and lumbar motion was evaluated through a combination of movement tests measured before and after the intervention using a validated computerized vision system. Post intervention assessment revealed a significant reduction in pain, with NPRS decreased. Radiologically, there was an observable increase in lumbar lordosis and improved intervertebral spacing. The lumbosacral angle improved markedly from 49.7° to 30.2°, nearing the normative range (p<0.0001). Functional testing demonstrated improved lumbar flexion and extension. The structured physiotherapy protocol was effective in reducing pain and inducing radiological and functional changes in a patient with sacralization. This case highlights the potential role of individualized manual and exercise-based interventions in managing biomechanical alterations due to sacralization.