Marko Stojco Spasov, Ilija Pane Todorov, Emilija Milan Stojkovska Pemovska


Introduction: Low back pain is common medical disorder that can be caused by different etiologies, some of them being very rare. During the past decades, much of the etiology and pato-mechanics of low back pain has been clarified. However, defining precise cause of low back pain in a small subset of patients is still challenging.

Case presentation: We are presenting a case of long lasting low back pain caused by impingement of the enlarged spinous process of the fifth lumbar spine into the spina bifida of the first sacral segment, so called De Anquin syndrome. We delineated the precise morphology of the anomaly using CT scans, and since the patient was symptomatic, the resection of the enlarged spinous process was undertaken. During the follow up period, the patient remained completely symptom free.

Discussion and Literature review: We undertook literature review and small number of studies describing De Anquin syndrome were found. The most remarkable finding of the case presented is the immediate and complete release of pain.

Conclusion: We do recommend seeking for the exact etiology in the patients with long lasting low back pain.


de Anquin syndrome, low back pain, clasp knife deformity, sciatica

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