Congenital Lumbar Vertebral Synostosis: A Case Report

Abstract

INTRODUCTION: Congenital spinal anomalies are structural irregularities present from birth that can affect health. Congenital vertebral synostosis is a rare condition resulting from improper vertebral fusion during embryonic development (VOLK et al., 2021). Early diagnosis and appropriate treatment are essential to prevent complications and ensure quality of life (XIMENES et al., 2004). This article reports the case of a young man with congenital lumbar vertebral synostosis who showed improvement with evidence-based medications. CASE REPORT: A 38-year-old male patient presented with lumbar pain radiating to the lower limbs and paresthesia in the left foot, improving with movement and the use of anti-inflammatory drugs but worsening with rest. He reported an unbalanced diet, sedentary lifestyle, and being overweight. He denied fever, trauma, or muscle weakness. Physical examination showed positive Lasegue and Patrick Fabere signs bilaterally. Initial treatment included advice on healthy habits, physical therapy, and analgesia, along with requesting a lumbar MRI. The exams revealed lumbar spondyloarthrosis, fusion between L2 and L3, and disc bulges touching the dural sac at L3-L4, L4-L5, and L5-S1, leading to the diagnosis of congenital lumbar vertebral synostosis. A new therapeutic approach included Pregabalin and Paracetamol + Codeine, emphasizing physical therapy and a healthy lifestyle. CONCLUSION: This diagnosis represents a clinical challenge due to the lack of a curative treatment. This case highlights the importance of early diagnosis and appropriate management to minimize complications and improve the patient's quality of life. Multimodal therapy, including medications, physical therapy, and lifestyle changes, is essential for symptom control and well-being.