Foramen on the sacral ala and the lumbar transverse process: reviewing not a very common observation

Detection of foramina at the sacral ala is not very uncommon and has been reported earlier in the literature. It has also been suggested that occurrence of such a foramen may be associated with similar findings at adjacent lumbar transverse processes. This report documents detection of a similar occurrence and reviews commonly accepted embryological explanations of this phenomenon. Pedicle or alar instrumentations in these individuals warrants careful per-operative imaging of these foramina due to the likelihood of these formina containing remnants of longitudinally anastomosing vascular structures, in most instances.