Eric Chun-Pu Chu
Spina bifida occulta (SBO) refers to a split in the spine that is concealed beneath the skin. The biomechanical impact of complete sacral SBO has often been underappreciated. This case highlights the potential effects of complete sacral SBO on the spine. A 12-year-old girl presented with truncal asymmetry and intermittent neck and lumbar pain lasting for two years. Initially, she was diagnosed with mild scoliosis during a school health screening and was placed under medical observation, but her symptoms worsened over time. Imaging studies revealed an inverted cervical lordosis along with a 25-degree left thoracolumbar curvature. Additionally, the laminae of all five sacral vertebrae were intact yet failed to fuse into a median crest, consistent with a diagnosis of complete sacral SBO. This anomaly was not noted in the patient's earlier medical documentation. The treatment aimed to improve spinal stability. Chiropractic care was provided weekly for 58 months, incorporating rhythmic massage, flexion-distraction techniques, and spinal manipulation. The patient reported complete resolution of neck and back pain, and her scoliotic curve was reduced to 17 degrees. This case underscores the biomechanical significance of sacral SBO in lumbosacral stability, an issue that has largely been overlooked in clinical research.