POLL: Do You Have a Sacral Dimple on Your Lower Back? (Can be Medically Significant, and May be Linked to ME/CFS)

[Hip]

I do not have a dimple but have a very distintive line, that runs up a bit. DOes that mean anything?

I am not sure. @ehc918 may know more about it.

This article mentions some related features found near or within the buttock crease which may signify neural tube issues:

• swelling in the area
• skin tags
• a birthmark in the area
• a patch of hair by the dimple
• a fatty lump
• a dimple larger or deeper than 5 millimeters (mm)
• discoloration
• tenderness

 

[ehc918]

Standard supine (laying on your back) lumbar MRI imaging can sometimes reveal a “tethered cord” where you have either a low conus (end of the cord which should be around L1) and/or attached filum, a fatty or thick filum- which does not mean it is causing issues btw. However, some of us have obtained lumbar MRI in prone position, laying on the stomach vs back, and this can sometimes show a “taut filum”. All nerve roots *should settle downward with gravity, but a remarkable number of us who have obtained clear prone images have evidence of this abnormality. I think I linked this is a previous comment above. It can be difficult to get clear imaging based on respiration movement. But I’ve created a protocol that a few people used which showed this anomaly. It feels like a clue, but I’m not sure what. Again, this will not show up on a lumbar MRI laying on your back- gravity will mask it.
My illness crept up on me slowly- no post viral onset however I do have abnormal CMV titers indicating chronic acute infection going back to at least 2007. Prior to that I was the picture of health.
As for the pronounced scar-like line (shown in my image in the original post, there is information talking about a sacral hypo/hyperpigmentation of the skin, but I can’t find out exactly what they are referring to. I do suspect that even these clear “lines” might indicate something. But I also think you can have a tethered cord that is asymptomatic.
I am waiting on several patients to report on their prone lumbar MRI’s and will report back on these findings and possibly share the protocol I developed. If nothing else I think it is helpful just to know. With that said, you can still have a tethered cord with normal prone imaging. Which is why such emphasis is placed on the symptoms driving diagnosis and intervention.

 

[Strawberry]

I want to awaken this thread.

When I voted a few weeks ago, it was based on a 40 year old memory of my arse crack. Just did the video technique and verified YES. So what exactly does this mean for treatments? I also am verified hypermobile, and have a very narrow jaw that is indicative of EDS. What sort of treatments are there for tethered cord? Or is surgery it? Does surgery for tethered cord solve all? I’m not sure about CCI, but I might have a diagnosis for AAI but don’t remember well. Definitely atlas something or other from about 15 years ago.

 

[ehc918]

So what exactly does this mean for treatments?

I'm not sure!!! It seems that for tethered cord symptoms you can try medical management, maybe physical therapy (not sure what that would look like) and surgery. Not sure at what point surgery would be recommended.

As for a cure all...I'm not sure any of "this" has a cure. And it's really a mixed bag with surgical outcomes over the past 18 months. Some have felt better, some haven't felt much improvement, some are worse. Most patients have ended up needing a tethered cord release which is really curious.

Over representation of sacral dimples/divots and over representation with tethered cords begs for research into this. Petra Klinge seems to be the only one doing any sort of research and she sends out the filum for biopsy and has found microscopic abnormalities- but how that ties in to MECFS symptoms is far from clear- yet.

 

[ChookityPop]

I have this weird misalignment. Is this a sacral dimple?

 

[Hip]

I have this weird misalignment. Is this a sacral dimple?

Possibly, but I am not sure. @ehc918 is the expert.

 

[pogoman]

I have this weird misalignment. Is this a sacral dimple?

Might even be scoliosis of some sort, maybe have a doctor look at it if you have back problems.

 

[Pyrrhus]

Might even be scoliosis of some sort, maybe have a doctor look at it if you have back problems.

...Especially if you also have pectus excavatum...

 

[ChookityPop]

...Especially if you also have pectus excavatum...

Interesting. They havent said anything about scoliosis yet, only that I have mild kyphosis. My chiropractor says its worse than mild.. Do you think it could be related to the cfs? I can post some pictures from my back MRI.

 

[Pyrrhus]

Interesting. They havent said anything about scoliosis yet, only that I have mild kyphosis. My chiropractor says its worse than mild.. Do you think it could be related to the cfs? I can post some pictures from my back MRI.

With kyphosis, the tailbone can stick out a bit, which is probably what is seen in the picture you shared. This might make it hard to determine if a sacral dimple exists.

But it sounds like your kyphosis and pectus excavatum are congenital conditions that you were born with? I don't know how they might be connected to ME, except if there is a congenital component to your ME.

Hope this helps.

 

[ChookityPop]

With kyphosis, the tailbone can stick out a bit, which is probably what is seen in the picture you shared. This might make it hard to determine if a sacral dimple exists.

But it sounds like your kyphosis and pectus excavatum are congenital conditions that you were born with? I don't know how they might be connected to ME, except if there is a congenital component to your ME.

Hope this helps.

Thanks, thats an interesting oberservation.

Yes they are congenital conditions I'm born with. I have a NUSS procedure coming up next year. I have to man up for that one. Wonder if it could do anything for my issues. And also wonder if I should wait a little bit more to go ahead with it..

 

[bensmith]

Pretty sure im a no.